American Journal of the Medical Sciences最新文献

{"title":"Microbial cell-free DNA as an adjunct for diagnosis of tuberculosis","authors":"Tina Agbaosi MD, Kerry O. Cleveland MD, Michael S. Gelfand MD","doi":"10.1016/j.amjms.2025.11.003","DOIUrl":"10.1016/j.amjms.2025.11.003","url":null,"abstract":"","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":"371 3","pages":"Pages 298-299"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145477081","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}

{"title":"TyG and TyG-BMI indices as predictive biomarkers for T2DM risk in overweight and obese individuals: Insights from the CHNS database clinical study","authors":"Ranhao Li MS ,&nbsp;Yangxingyun Wang MS ,&nbsp;Wei Wang MD","doi":"10.1016/j.amjms.2025.11.006","DOIUrl":"10.1016/j.amjms.2025.11.006","url":null,"abstract":"<div><h3>Background</h3><div>Diabetes mellitus (DM) is a metabolic disorder that lacks specific early diagnostic markers and is often associated with serious complications and comorbidities. The triglyceride-glucose index (TyG) and the triglyceride-glucose-body mass index (TyG-BMI) are key metabolic indicators related to insulin resistance and β-cell dysfunction. However, their association with the development of type 2 diabetes mellitus (T2DM) remains unclear. This study aimed to examine the relationship between TyG and TyG-BMI levels and the incidence of T2DM, evaluate their predictive performance, and support the identification of populations at high risk for T2DM.</div></div><div><h3>Methods</h3><div>Data were obtained from the 2009 China Health and Nutrition Survey (CHNS), including 9498 participants. TyG and TyG-BMI were calculated, and their associations with T2DM risk were assessed using a Cox regression model. Predictive performance was evaluated with receiver operating characteristic (ROC) curve analysis.</div></div><div><h3>Results</h3><div>In the overall population, including both sexes, individuals aged &gt;50 years and ≤50 years, and both urban and rural residents, higher TyG and TyG-BMI levels were independently associated with T2DM, showing a linear dose-response relationship. Both indicators demonstrated predictive value for T2DM, with TyG-BMI showing stronger associations, a larger area under the ROC curve, and greater clinical relevance.</div></div><div><h3>Conclusions</h3><div>These results suggest that both TyG and TyG-BMI are useful predictors of T2DM, with TyG-BMI providing superior predictive accuracy. These findings support the use of these indices in the early screening of high-risk T2DM populations.</div></div>","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":"371 3","pages":"Pages 237-246"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145491297","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}

{"title":"Vagus nerve stimulation as a novel therapeutic approach for musculoskeletal diseases","authors":"Shivmurat Yadav PhD ,&nbsp;Stavros Stavrakis MD, PhD ,&nbsp;Constance R. Chu MD ,&nbsp;Mary Beth Humphrey MD, PhD","doi":"10.1016/j.amjms.2025.09.005","DOIUrl":"10.1016/j.amjms.2025.09.005","url":null,"abstract":"<div><div>Vagus nerve stimulation (VNS) has gained significant attention as a therapy for various medical conditions due to its ability to modulate chronic diseases, pain, and inflammation. VNS delivered by an implanted device is FDA approved for severe epilepsy and refractory depression. VNS delivered with implantable devices or transcutaneous methods are now being studied in several musculoskeletal diseases including osteoarthritis, rheumatoid arthritis, systemic lupus erythematosus, and fibromyalgia. VNS activates the neuroimmune axis including the cholinergic anti-inflammatory pathway (CAP), suppressing inflammation and reducing pain. Here, we review the pathophysiology of VNS and the outcomes from clinical trials in musculoskeletal diseases. We address the limitations of these studies, including the inconsistent use of physiological biomarkers, such as heart rate variability, to ensure that VNS is engaging the vagus nerve. More studies are required to reveal the full potential of VNS for pain reduction and disease modification.</div></div>","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":"371 3","pages":"Pages 208-215"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008628","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}

{"title":"Changes in perceived neighborhood environments by COVID-19: A nationwide Korean survey","authors":"Ki Dong Ko PhD ,&nbsp;In Cheol Hwang PhD ,&nbsp;Hong Yup Ahn PhD","doi":"10.1016/j.amjms.2025.09.008","DOIUrl":"10.1016/j.amjms.2025.09.008","url":null,"abstract":"","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":"371 3","pages":"Pages 295-297"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088810","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}

{"title":"Place of death from asthma among adults aged 65 and Older, 1999–2023","authors":"Guodong Ding PhD MD ,&nbsp;Changgen Li MD ,&nbsp;Angela Vinturache PhD MD ,&nbsp;Yongjun Zhang PhD MD","doi":"10.1016/j.amjms.2025.08.011","DOIUrl":"10.1016/j.amjms.2025.08.011","url":null,"abstract":"","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":"371 3","pages":"Pages 300-303"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862752","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}

{"title":"Association between hemodynamic instability and noninvasive ventilation failure: A large multicenter observational study","authors":"Hongbo Zhou RN ,&nbsp;Xiaoyi Liu MD, PhD ,&nbsp;Ke Wang MD, PhD ,&nbsp;Weiwei Shu MD, PhD ,&nbsp;Mengyi Ma MD, PhD ,&nbsp;Xiaofang Zhang MD, PhD ,&nbsp;Jun Duan MD, PhD","doi":"10.1016/j.amjms.2025.10.019","DOIUrl":"10.1016/j.amjms.2025.10.019","url":null,"abstract":"<div><h3>Background</h3><div>Hemodynamic instability is a relative contraindication for noninvasive ventilation (NIV). However, there is limited evidence supporting this contraindication.</div></div><div><h3>Methods</h3><div>This prospective multicenter observational study across 18 Chinese and Turkish hospitals enrolled acute hypoxemic respiratory failure patients receiving NIV. Hemodynamic instability was defined as requiring vasoactive agents to maintain mean arterial pressure (MAP) &gt;70 mmHg within 24 h of NIV. Reversible instability indicated vasoactive agent discontinuation by 24 h, while irreversible instability required persistent vasopressor use.</div></div><div><h3>Results</h3><div>Among 2137 enrolled patients, 279 (13 %) developed hemodynamic instability. Compared to hemodynamically stable patients, those with instability had significantly higher rates of NIV failure (56 % vs. 37 %; adjusted OR =1.89, 95 % CI: 1.37–2.59). NIV failure rates increased with the severity of hemodynamic impairment: 37 % in patients requiring no vasopressors, 54 % in those on one vasopressor, and 70 % in those requiring multiple vasopressors (<em>p</em> &lt; 0.01 across groups). Within the unstable cohort, 55 patients (20 %) achieved hemodynamic stabilization within 24 h. Subsequent analysis showed that reversible instability was not significantly associated with NIV failure (adjusted OR =0.60, 95 % CI: 0.30–1.21), whereas irreversible instability was strongly associated with NIV failure (adjusted OR =2.48, 95 % CI: 1.75–3.53).</div></div><div><h3>Conclusions</h3><div>Hemodynamic instability is associated with NIV failure. The likelihood of failure increases with the severity of the hemodynamic instability. However, if the instability is effectively reversed within the first 24 h, it is no longer associated with an increased risk of NIV failure.</div></div>","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":"371 3","pages":"Pages 216-220"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145370601","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}

{"title":"Real world evaluation of Evusheld in prevention of COVID-19 in immunocompromised patients: An observational cohort study","authors":"Sarah Channey Pharm.D. ,&nbsp;Pramodini Kale-Pradhan Pharm.D., FCCP, FIDSA, Professor (Clinical) ,&nbsp;Mamta Sharma MD, FACP, FIDSA, FSHEA ,&nbsp;Daniel Lebovic MD, Division Chief ,&nbsp;Christopher Giuliano Pharm.D., MPH, Professor (Clinical) ,&nbsp;Leonard Johnson MD, FIDSA ,&nbsp;Ashish Bhargava MD, FIDSA","doi":"10.1016/j.amjms.2025.11.007","DOIUrl":"10.1016/j.amjms.2025.11.007","url":null,"abstract":"<div><h3>Background</h3><div>Evusheld®, a combination of monoclonal antibodies Tixagevimab and Cilgavimab, was developed for pre-exposure prophylaxis (PrEP) of coronavirus disease 2019 (COVID-19) in immunocompromised patients. However, real-world long-term data on its effectiveness against SARS-CoV-2 Omicron variants remain limited.</div></div><div><h3>Methods</h3><div>A retrospective cohort was conducted on patients ≥18 years old who received the Evusheld from December 1, 2021, to January 31, 2023, at six Ascension hospitals in Southeast Michigan. Patients included were those with active solid tumor and hematologic malignancies or undergoing immunosuppressive treatment, including CAR-T therapy, biologic agents, or high-dose corticosteroids (≥20 mg prednisone or equivalent per day for ≥2 weeks). Data collected included patient demographics, development of COVID-19 post-Evusheld, ICU length of stay (LOS), hospital LOS, ventilation requirement and duration, and mortality within six months post-therapy.</div></div><div><h3>Results</h3><div>Among 663 patients screened, 316 were included after excluding duplicates and patients that did not receive the ordered Evusheld regimen. Among them, 204 patients received two doses of Evusheld and 112 received only one dose. In the two-dose group, 18 (8.8%) tested positive for COVID-19 within 180 days post-Evusheld, while 11 (9.8%) in the one-dose group tested positive. Notably, none of the COVID-positive patients in either group required hospitalization, mechanical ventilation, or succumbed to the disease.</div></div><div><h3>Conclusions</h3><div>Within six months of Evusheld administration, immunocompromised patients showed no episodes of rehospitalization, mechanical ventilation, or death, and experienced low rates of severe COVID-19.</div></div>","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":"371 3","pages":"Pages 255-258"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145590618","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}

{"title":"Why Alexis Carrel, later Nobel laureate, left France for the United States: A reappraisal","authors":"Mathieu Ginier-Gillet MD ,&nbsp;Alessandro de Franciscis MD, ScM","doi":"10.1016/j.amjms.2025.11.010","DOIUrl":"10.1016/j.amjms.2025.11.010","url":null,"abstract":"<div><div>The life of Alexis Carrel, recipient of the 1912 Nobel Prize in Physiology or Medicine, is closely linked to Lourdes and the religious tensions that marked twentieth-century France. In 1902, he traveled to Lourdes. Upon his return, his account of the cure of Marie Bailly—a twenty-three-year-old woman suffering from peritonitis according to several physicians—caused a scandal in French academic circles. His Chief of Surgery subsequently dismissed him. In 1904, he went into exile in Canada, then the United States, where he established connections with Charles Claude Guthrie, Hervey Cushing and Simon Flexner, who welcomed him to the Rockefeller Institute. Over the years, Carrel lost all contact with Marie Bailly. Decades later, in the 1930s and again in the 1960s, attempts to reopen her medical records met with limited success. Was it a case of tubercular peritonitis or pseudoperitonitis? A misinterpretation—or an exceptional recovery? This article reexamines the case of Marie Bailly based on unpublished documents from the Sanctuary of Lourdes Archives, including Carrel’s original notes.</div></div>","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":"371 3","pages":"Pages 201-207"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145644112","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}

{"title":"A study of the correlation between serum bile acid profile and prognosis in patients with sepsis","authors":"Yuzhi Xu MM ,&nbsp;Jingtao Zhang MB ,&nbsp;Yuxin Lu MB ,&nbsp;Wanglin Zhang MB ,&nbsp;Hongwei Shi MB ,&nbsp;Qi Liang MM ,&nbsp;Yingchen Wang MM ,&nbsp;Liqun Sun MD","doi":"10.1016/j.amjms.2025.10.022","DOIUrl":"10.1016/j.amjms.2025.10.022","url":null,"abstract":"<div><h3>Objective</h3><div>Sepsis remains a major global health challenge, with high mortality associated with multi-organ dysfunction, faster identification and assessment of sepsis is beneficial to guide treatment. Studies have found changes in the composition of bile acids (BAs) in the serum and stool of patients with sepsis compared to healthy individuals, so we sought to explore changes in serum BAs in patients with sepsis and their correlation with prognosis.</div></div><div><h3>Methods</h3><div>This prospective study enrolled healthy individuals and sepsis patients admitted to the Intensive Care Unit of the Second Affiliated Hospital of Nanjing Medical University between January 2023 and January 2024. Clinical data were collected, and serum levels of 15 BAs were quantified using liquid chromatography-tandem mass spectrometry. Patients were categorized into groups based on 28-day outcomes, severity of illness, and infection source for subsequent analysis.</div></div><div><h3>Results</h3><div>Compared with healthy individuals, the secondary BAs in sepsis patients were significantly lower, among which ursodeoxycholic acid (UDCA) is below the reference range. Compared with the survivors, the taurocholic acid (TCA) and taurodeoxycholic acid (TDCA) of the non-survivors of sepsis were significantly increased, while the UDCA was further decreased. Patients with pulmonary infection exhibited higher overall BA levels than those with abdominal infection. Both TCA and TDCA correlated positively with bilirubin, while UDCA correlated negatively with SOFA scores, C-reactive protein, and procalcitonin. In univariate COX regression, UDCA was associated with 28-day mortality (HR =0.990, <em>P</em>=0.042). ROC analysis showed that the area under the curve for UDCA predicting 28-day mortality was 0.643 (<em>P</em>=0.034).</div></div><div><h3>Conclusions</h3><div>Secondary BAs were significantly reduced in sepsis patients, with UDCA showing the most pronounced decrease. This reduction becomes even more substantial in non-survivors. The overall BA levels were significantly higher in patients with pulmonary infection than in those with abdominal infection. UDCA was negatively correlated with SOFA score, CRP, and PCT in sepsis patients, and combining it with other indicators improves the prediction of sepsis prognosis. These results indicate that UDCA may exert a protective effect in sepsis.</div></div>","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":"371 3","pages":"Pages 226-236"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145423756","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}

{"title":"Cardiac sarcoidosis a brief review of the evolving role of diagnostic imaging","authors":"Bethanne Venkatesan MD,&nbsp;Jesse Roman MD,&nbsp;Daniel Kramer MD","doi":"10.1016/j.amjms.2025.10.024","DOIUrl":"10.1016/j.amjms.2025.10.024","url":null,"abstract":"<div><div>Cardiac Sarcoidosis (CS) is a potentially life-threatening manifestation of sarcoidosis that presents significant diagnostic and management challenges. While only 2–5 % of patients with sarcoidosis are diagnosed with CS, autopsy studies have demonstrated a prevalence as high as 25 % suggesting the condition is often under recognized likely because of lack of or nonspecific symptoms or diagnostic limitations. Considering the unreliability and invasiveness of endomyocardial biopsy, cardiac magnetic resonance imaging (CMR) and Fluorodeoxyglucose F18 (FDG) positron emission tomography (PET) have become useful diagnostic modalities in suspected cases of CS. However, there is scarce data in support of one imaging modality over the other and each has its limitations. Such limitations are depicted in the case of a patient with complete heart block and newly diagnosed sarcoidosis showing conflicting results on FDG-PET and CMR. A narrative review of current knowledge on this condition and about the imaging modalities available for the workup of CS is provided.</div></div>","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":"371 3","pages":"Pages 281-285"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145433633","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}