American Journal of the Medical Sciences最新文献

{"title":"Global longitudinal strain and the risk of major adverse cardiac events in post-myocardial infarction patients: A retrospective cohort study","authors":"Qiao Guo MD ,&nbsp;Weilong Hong MD ,&nbsp;Dan Li MD ,&nbsp;Ruixue Liu MD ,&nbsp;Lumiao Liu MD ,&nbsp;Xuxin Tan MD ,&nbsp;Guangyou Duan PhD ,&nbsp;He Huang PhD ,&nbsp;Chenyang Duan PhD","doi":"10.1016/j.amjms.2024.07.015","DOIUrl":"10.1016/j.amjms.2024.07.015","url":null,"abstract":"<div><h3>Background</h3><div>This study evaluates the relationship between global longitudinal strain (GLS) and late major adverse cardiovascular events (MACEs) in patients after acute myocardial infarction (AMI).</div></div><div><h3>Methods</h3><div>Data of newly diagnosed AMI patients between March 2010 and July 2014 were retrospectively evaluated. The patients underwent serial echocardiography at admission and at third and sixth months post-admission. We calculated GLS by averaging the strain from all myocardial segments using speckle-tracking echocardiography (STE). We used multivariate Cox regression analysis and receiver operating characteristic (ROC) curve analyses to assess the relationship between GLS at admission and late MACEs.</div></div><div><h3>Results</h3><div>Eighty-nine newly diagnosed AMI patients were enrolled. The average age at diagnosis was 61 ± 12.5 years, and approximately 89.9% of the patients were men. The average level of GLS was -17.5 ± 3.9%. The overall prevalence of MACEs was 23.6% (21/89), compared with 44% (11/25) in the group with GLS≥-15% and 17.9% (5/28) in the group with GLS&lt;-20%. GLS was positively linked with MACEs in the fully adjusted Cox proportional hazard model (hazard ratio [HR], 1.19; 95% confidence interval [CI], 1.04–1.37; <em>P</em>=0.014) after adjusting potential confounders. The ROC curve analysis for one year MACEs between GLS at admission, with the most significant area under the curve(AUC) 78.1% (95% CI, 63.8% - 92.6%).</div></div><div><h3>Conclusions</h3><div>Myocardial dysfunction, characterized by impaired GLS, is often observed in AMI patients, and a decrease in GLS levels at admission were associated with an increased risk of long-term MACEs in post-myocardial infarction patients.</div></div>","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141602404","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":"Meta-analysis of renin angiotensin aldosterone modulators mitigating atrial fibrillation risk in hypertensive patients","authors":"Arankesh Mahadevan MBBS ,&nbsp;Sushmitha Garikipati MBBS ,&nbsp;Samir Vanani MBBS ,&nbsp;Dakshin Meenashi Sundaram MBBS ,&nbsp;Ashley Thompson-Edwards MBBS ,&nbsp;Nafisa Reyaz MBBS ,&nbsp;Kalaivani Babu MBBS ,&nbsp;Srinishant Rajarajan MBBS ,&nbsp;Dhayashri Dhavapalani MBBS ,&nbsp;Dharshana Prem Anand MBBS ,&nbsp;Advait Vasavada MBBS ,&nbsp;Rupak Desai MBBS","doi":"10.1016/j.amjms.2024.07.016","DOIUrl":"10.1016/j.amjms.2024.07.016","url":null,"abstract":"<div><h3>Introduction</h3><div>Hypertension is associated with left ventricular hypertrophy/enlargement/fibrosis and atrial ectopic rhythm, leading to an increased risk of Atrial Fibrillation (AF). We aimed to stratify the effect of Angiotensin Converting Enzyme Inhibitors (ACEi) and Angiotensin Receptor Blockers (ARB) on the risk of AF.</div></div><div><h3>Methods</h3><div>PubMed, Scopus, and Google Scholar databases were screened, and cross-citation was conducted for studies reporting AF in hypertensive patients on ACEi and ARB. Of 145 studies found till May 2023, 19 were included in this study. Binary random-effects models estimated the pooled odds ratios, I2 statistics assessed heterogeneity and sensitivity analysis was assessed using the leave-one-out method.</div></div><div><h3>Results</h3><div>153,559 hypertensive patients met the inclusion criteria. For incidental AF, ACEi and ARB showed a significant decrease in both unadjusted (OR 0.75, 95% CI [0.66-0.85], I² = 20.79%, <em>p</em>=0.29) and adjusted risks (OR 0.76, 95% CI [0.62–0.93], I² = 88.41%, <em>p</em>&lt;0.01). In recurrent AF, the unadjusted analysis showed no significant effect (OR 0.89, 95% CI [0.55–1.42], I² = 78.44%, <em>p</em>&lt;0.01), while the adjusted analysis indicated a reduced risk (OR 0.62, 95% CI [0.50–0.76], I² = 65.71%, <em>p</em>&lt;0.01). Leave-one-out sensitivity analysis confirmed these results.</div></div><div><h3>Conclusions</h3><div>ACEi and ARB considerably decrease the risk of incidental and recurrent AF in hypertensive patients, emphasizing the importance of treating clinical hypertension with these drugs.</div></div>","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141602405","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":"Outcome of Guillain-Barré syndrome with bulbar palsy","authors":"Jayantee Kalita MD ,&nbsp;Roopali Mahajan MD ,&nbsp;Sanjeev K. Bhoi MD ,&nbsp;Usha K Misra MD","doi":"10.1016/j.amjms.2024.07.010","DOIUrl":"10.1016/j.amjms.2024.07.010","url":null,"abstract":"<div><h3>Background</h3><div>Elective intubation is advocated in Guillain-Barré syndrome (GBS) with bulbar palsy to prevent aspiration pneumonia and lung collapse. We evaluate the outcome of GBS patients with bulbar palsy, and also compare the risks and benefits of intubation and MV in them.</div></div><div><h3>Methods</h3><div>187 GBS patients with bulbar palsy from a cohort of 547 GBS registry were analyzed. Detailed clinical records and peak disability on a 0-6 GBS Disability Scale (GBSDS) were noted. The patients were intubated if arterial blood gas (ABG) analysis revealed hypoxia, hypercarbia or acidosis. The patients with normal ABG parameters were fed by nasogastric tube, and nursed in lateral position. Occurrence of pneumonia, in-hospital death and outcomes at 6-months were classified as complete (GBSDS &lt;2), partial (GBSDS 2-3) and poor (GBSDS &gt;3).</div></div><div><h3>Results</h3><div>76/187(40.6%) patients required MV, and they had a shorter duration of illness (p = 0.007), higher peak disability (p &lt; 0.001), autonomic dysfunction (p &lt; 0.001) and more frequently received IVIg (p = 0.02). Pneumonia (63% vs 10.8%; p &lt; 0.001) and in-hospital deaths (7.9% vs 1.8%; p = 0.06) were more frequent in MV group compared to nasogastric fed group. At 6-months,104 (55.6%) patients recovered completely. On multivariate analysis, the independent predictors of poor outcome were peak disability [Adjusted Odds Ratio (AOR) 9.84, 95% Confidence Interval (CI) 3.15-30.74, p &lt; 0.0001], day of hospitalization from disease onset (AOR 1.09, 95% Cl 1.01-1.01; p=0.009) and requirement of MV (AOR 0.10; 95% 0.02-0.50; p = 0.005).</div></div><div><h3>Conclusion</h3><div>GBS patients with bulbar palsy may be managed by nasogastric feeding and nursing in lateral position without increasing the risk of pneumonia. Mechanical ventilation based on ABG does not worsen outcomes of GBS with bulbar palsy.</div></div>","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592167","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":"Associations between serum uric acid and breast cancer incidence: A systematic review and meta-analysis","authors":"Xiao Xue MM,&nbsp;Zhengyi Sun BM,&nbsp;Xufeng Ji MM,&nbsp;Hua Lin MM,&nbsp;Huang Jing MD,&nbsp;Qiuyang Yu MM","doi":"10.1016/j.amjms.2024.07.005","DOIUrl":"10.1016/j.amjms.2024.07.005","url":null,"abstract":"<div><h3>Background</h3><div>Serum uric acid (SUA) may be involved in the development of cancer by inhibiting oxidative stress, but its relationship with breast cancer remains unclear.</div></div><div><h3>Materials and Methods</h3><div>The PubMed, Embase, and Web of Science databases were searched systematically for studies on SUA levels in women with breast cancer and the effect of SUA levels on the risk of breast cancer. The Newcastle‒Ottawa Quality Assessment Scale (NOS) was used to assess the quality of all relevant studies included.</div></div><div><h3>Results</h3><div>A total of 19 studies were included, including 75,827 women with breast cancer and 508,528 healthy controls. A meta-analysis found that SUA levels were negatively correlated with breast cancer risk in women (HR = 0.94, 95% CI: 0.89 - 0.99, <em>p</em> = 0.003). SUA levels in female breast cancer patients were not significantly different from those in healthy controls (SMD = 0.49, 95% CI = -0.09 - 1.08, <em>p</em> = 0.10), while SUA levels were increased in female breast cancer patients in articles published after 2010, SUA concentration detected by spectrophotometry, and non-Asian populations, regardless of menopausal state and treatment state.</div></div><div><h3>Conclusion</h3><div>High levels of SUA may reduce the risk of breast cancer in women, suggesting that SUA was a protective factor in women.</div></div>","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of the combination or monotherapy with GLP-1 receptor agonists and SGLT-2 inhibitors in Type 2 diabetes mellitus: An update systematic review and meta-analysis","authors":"Adili Tuersun MA ,&nbsp;Guanxin Hou BA ,&nbsp;Gang Cheng PhD","doi":"10.1016/j.amjms.2024.07.011","DOIUrl":"10.1016/j.amjms.2024.07.011","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the efficacy and safety of combination therapy with sodium-glucose cotransporter2(SGLT-2) inhibitors and glucagon-like peptide-1(GLP-1) receptor agonists in the treatment of type 2 diabetes mellitus (T2DM).</div></div><div><h3>Methods</h3><div>To construct an exhaustive database of randomized controlled trials (RCTs) concerning SGLT-2 inhibitors and GLP-1 agonists, a methodical search was undertaken across a range of databases, such as Embase, PubMed, and the Cochrane Central Register of Controlled Trials, from their inception to January 2023. Following this, a meta-analysis was executed to amalgamate the collected data, which allowed for the calculation of standardized mean differences (SMDs), odds ratios (ORs), and 95 % confidence intervals (CIs) for a spectrum of outcomes. This analytical approach was designed to yield a quantitative evaluation of the therapeutic efficacy and safety profile of SGLT-2 inhibitors and GLP-1 agonists for the treatment of diabetes mellitus.</div></div><div><h3>Results</h3><div>When compared to GLP-1 agonist therapy alone, the combination therapy did not significantly reduce fasting plasma glucose (FPG) levels (95 % confidence interval [CI]: -0.27, 0.10; <em>p</em> = 0.35), body weight (95 % CI: -0.18, 0.18; <em>p</em> = 1.00), Glycosylated Hemoglobin, Type A1C (HbA1c) (95 % CI: -0.29, 0.07; <em>p</em> = 0.22), or systolic blood pressure (SBP) values (95 % CI: -0.29, 0.06; <em>p</em> = 0.21). In contrast, when compared to SGLT-2 inhibitor therapy alone, combination therapy significantly decreased FPG by 0.24 mmol/L (95 % CI: -0.43, -0.05; <em>p</em> = 0.01), HbA1c by 0.45 % (95 % CI: -0.72, -0.18; <em>p</em> = 0.001), and SBP by 0.12 mmHg (95 % CI: -0.24, 0.00; <em>p</em> = 0.05). However, the combination therapy failed to demonstrate a significant reduction in body weight when compared with either SGLT-2 inhibitor therapy (95 % CI: -0.20, 0.05; <em>p</em> = 0.24) or GLP-1 agonist therapy (95 % CI: -0.18, 0.18; <em>p</em> = 1.00). Additionally, the combination therapy did not increase the incidence of hypoglycemia. It should be noted that data regarding mortality and cardiovascular outcomes were limited.</div></div><div><h3>Conclusions</h3><div>The combination treatment of SGLT-2 inhibitors and GLP-1 receptor agonists effectively reduces HbA1c, FPG, and SBP without elevating the risk of hypoglycemia when compared to monotherapy with SGLT-2 inhibitors. However, these beneficial effects were not observed when the combination therapy was compared with GLP-1 receptor agonist treatment alone.</div></div>","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560666","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":"Long-term trends in lifestyle factors among respondents with dyslipidemia in the United States","authors":"Bingqing Bai MM ,&nbsp;Quanjun Liu MM ,&nbsp;Yuting Liu MD ,&nbsp;Fengyao Liu MM ,&nbsp;Yu Wang MD ,&nbsp;Yilin Chen MM ,&nbsp;Yanting Liang MM ,&nbsp;Haochen Wang MM ,&nbsp;Chao Wu PhD ,&nbsp;Lan Guo PhD ,&nbsp;Huan Ma PhD ,&nbsp;Qingshan Geng PhD","doi":"10.1016/j.amjms.2024.06.025","DOIUrl":"10.1016/j.amjms.2024.06.025","url":null,"abstract":"<div><h3>Objectives</h3><div>To explore the long-term trends in unhealthy lifestyle factors and the risk sociodemographic subgroups among people with dyslipidemia.</div></div><div><h3>Methods</h3><div>Data extracted from the 1999 to 2018 National Health and Nutrition Examination Survey (NHANES). Lifestyle factors were smoking status, alcohol drinking, obesity, dietary quality, depression, physical activity, and sedentary behavior. A Joinpoint regression model was used to estimate trends in the log-transformed age-standardized prevalence. Multinomial logistic regression models adjusted for age, sex, and race/ethnicity were used to analyze subgroups by sociodemographic factors.</div></div><div><h3>Results</h3><div>Data for 33,680 respondents were extracted between 1999 and 2018. The prevalence of smoking and poor-quality diet decreased from 1999 to 2018 (<em>P</em>&lt;0.001), while obesity significantly increased (<em>P</em>&lt;0.001). The prevalence of depression marginally increased from 2005 to 2018 (<em>P</em>=0.074). We observed that non-Hispanic Black individuals, Hispanics, males, as well as those with lower family income-to-poverty ratios and education levels, unemployed individuals, or those lacking a spouse/live-in partner, were at elevated risk of unhealthy lifestyle factors when compared to the reference groups.</div></div><div><h3>Conclusions</h3><div>Among NHANES respondents from 1999 to 2018 with dyslipidemia, significant reductions in the prevalence of current smoking and poor diet were observed, while the prevalence of obesity was markedly increased. There were sociodemographic differences in the management of lifestyle factors. Further initiatives to encourage people with dyslipidemia are required to reduce potential adverse outcomes.</div></div>","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare observation in a case of Williams-Campbell syndrome","authors":"Chun Ian Soo FCCP ,&nbsp;Wai Ling Leong MRad (UM) ,&nbsp;Leng Cheng Sia MRCP(UK)","doi":"10.1016/j.amjms.2024.06.031","DOIUrl":"10.1016/j.amjms.2024.06.031","url":null,"abstract":"","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141478299","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":"Associations between metabolic dysfunction-associated fatty liver disease and atherosclerotic cardiovascular disease","authors":"Wen Wen MB ,&nbsp;Hua Fan MD, PhD ,&nbsp;Shenghui Zhang MB ,&nbsp;Siqi Hu MB ,&nbsp;Chen Chen MB ,&nbsp;Jiake Tang MB ,&nbsp;Yao You MB ,&nbsp;Chunyi Wang MB ,&nbsp;Jie Li MD, PhD ,&nbsp;Lin Luo MS ,&nbsp;Yongran Cheng MS ,&nbsp;Mengyun Zhou MD ,&nbsp;Xuezhi Zhao MD, PhD ,&nbsp;Tao Tan PhD ,&nbsp;Fangfang Xu MS ,&nbsp;Xinyan Fu MS ,&nbsp;Juan Chen MS ,&nbsp;Peng Dong MD, PhD ,&nbsp;Xingwei Zhang MD, PhD ,&nbsp;Mingwei Wang MD, PhD ,&nbsp;Yan Feng MB","doi":"10.1016/j.amjms.2024.06.022","DOIUrl":"10.1016/j.amjms.2024.06.022","url":null,"abstract":"<div><div>Non-alcoholic fatty liver disease<span><span> (NAFLD) is closely related to metabolic syndrome<span> and remains a major global health burden. The increased prevalence of obesity and type 2 diabetes mellitus (T2DM) worldwide has contributed to the rising incidence of NAFLD. It is widely believed that </span></span>atherosclerotic cardiovascular disease<span><span><span> (ASCVD) is associated with NAFLD. In the past decade, the clinical implications of NAFLD have gone beyond liver-related morbidity and mortality, with a majority of patient deaths attributed to malignancy, </span>coronary heart disease (CHD), and other cardiovascular (CVD) complications. To better define </span>fatty liver disease<span> associated with metabolic disorders, experts proposed a new term in 2020 - metabolic dysfunction associated with fatty liver disease (MAFLD). Along with this new designation, updated diagnostic criteria were introduced, resulting in some differentiation between NAFLD and MAFLD patient populations, although there is overlap. The aim of this review is to explore the relationship between MAFLD and ASCVD based on the new definitions and diagnostic criteria, while briefly discussing potential mechanisms underlying cardiovascular disease in patients with MAFLD.</span></span></span></div></div>","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141474133","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":"Characteristics of atypical pulmonary tuberculosis without typical clinical features diagnosed by pathology","authors":"Xi Wang M.S. ,&nbsp;Dandan Zhang M.S. ,&nbsp;Qiuxia Sun M.S. ,&nbsp;Yan You M.S. ,&nbsp;Jian Lan M.D.","doi":"10.1016/j.amjms.2024.06.023","DOIUrl":"10.1016/j.amjms.2024.06.023","url":null,"abstract":"<div><h3>Purpose</h3><div>Some patients with pulmonary tuberculosis (PTB) do not display typical clinical features, leading to delays in diagnosis and treatment.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed PTB patients admitted to the Second Affiliated Hospital of Chongqing Medical University between 2017 and 2020. They are divided into pathological group (diagnosed through pathological biopsy) and control group (diagnosed via sputum or lavage fluid). Clinical data of both groups were compared. Based on radiographic features, the pathological group was further divided into the inflammation group, peripheral nodule group, and central occupancy group. We then statistically analyzed the computed tomography (CT) signs, bronchoscopic manifestations and results of pathological biopsy for each subgroup.</div></div><div><h3>Results</h3><div>The pathological group consisted of 75 patients, while the control group had 338 patients. Multivariate logistic regression analysis showed that the pathological group had more diabetes (OR = 3.266, 95% CI = 1.609–6.630, <em>P</em> = 0.001), lower ESR (OR = 0.984, 95% CI = 0.971–0.998, <em>P</em> = 0.022), and lower CRP (OR = 0.990, 95% CI = 0.980–0.999, <em>P</em> = 0.036). In the three subgroups, the exudative lesions in the inflammation group were mostly located in atypical areas of PTB. The lobulation sign and spiculation sign were frequently observed in the peripheral nodule group. All presented with significant hilar mediastinal lymphadenopathy in the central occupancy group. In the pathological group, bronchoscopic manifestations typically included mucosal edema and bronchial stenosis.</div></div><div><h3>Conclusion</h3><div>Diabetes is an independent risk factor for atypical PTB. Expression of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) in atypical PTB is low. Radiologically, it is most easily misdiagnosed when presented as peripheral solid nodules or masses, so a biopsy is recommended.</div></div>","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141474134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single RIIA-type coronary artery anomaly with left ventricular fistula","authors":"Leizhi Ku ,&nbsp;Xiaojing Ma","doi":"10.1016/j.amjms.2024.06.017","DOIUrl":"10.1016/j.amjms.2024.06.017","url":null,"abstract":"","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141441194","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}