American Journal of the Medical Sciences最新文献_第2页

Association of pulmonary function test abnormalities and quality-of-life measures after COVID-19 infection COVID-19 感染后肺功能测试异常与生活质量的关系

IF 2.3 4区医学

American Journal of the Medical Sciences Pub Date : 2024-08-01 DOI: 10.1016/j.amjms.2024.04.010

{"title":"Association of pulmonary function test abnormalities and quality-of-life measures after COVID-19 infection","authors":"","doi":"10.1016/j.amjms.2024.04.010","DOIUrl":"10.1016/j.amjms.2024.04.010","url":null,"abstract":"<div><h3>Background</h3><p>Long-COVID is a multisystem disease that can lead to significant impairments in health-related quality of life (HRQoL). Following COVID-19 infection, abnormalities on pulmonary function tests (PFT) are common. The primary aim of this study is to evaluate for any correlation between PFT abnormalities and impairment in HRQoL scores following COVID-19 infection.</p></div><div><h3>Methods</h3><p>This is an analysis of a prospective cohort of patients in Louisville, KY who were infected with COVID-19. Data collected included demographics, past medical history, laboratory tests, PFTs, and several HRQoL questionnaires such as the EuroQol 5 Dimension HRQoL questionnaire (EQ-5D-5 L), Generalized Anxiety Disorder 7 (GAD-7), Patient Health Questionnaire (PHQ-9), and Posttraumatic stress disorder checklist for DSM-5 (PCL-5). Descriptive statistics were performed, comparing PFTs (normal vs abnormal) and time since COVID-19 infection (3- vs 6- vs ≥ 12 months).</p></div><div><h3>Results</h3><p>There were no significant differences in FEV1, FVC, or the percentage of patients with abnormal PFTs over time after COVID-19 infection. Following COVID-19, patients with normal PFTs had worse impairment in mobility HRQoL scores and change in GAD-7 scores over time. There were no differences over time in any of the HRQoL scores among patients with abnormal PFTs.</p></div><div><h3>Conclusions</h3><p>Among patients with an abnormal PFT, there was no temporal association with HRQoL scores as measured by EQ-5D-5 L, GAD-7, PHQ-9, and PCL-5. Among patients with a normal PFT, mobility impairment and anxiety may be associated with COVID-19 infection. Following COVID-19 infection, impairment in HRQoL scores is not completely explained by the presence of abnormalities on spirometry.</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":"140771671","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

An unusual cause of gastrointestinal bleeding: “Watermelon stomach” 胃肠道出血的不寻常原因："西瓜胃

IF 2.3 4区医学

American Journal of the Medical Sciences Pub Date : 2024-08-01 DOI: 10.1016/j.amjms.2024.03.011

引用次数: 0

Use of tumor markers in distinguishing lung adenocarcinoma-associated malignant pleural effusion from tuberculous pleural effusion 利用肿瘤标记物区分肺腺癌相关恶性胸腔积液和结核性胸腔积液

IF 2.3 4区医学

American Journal of the Medical Sciences Pub Date : 2024-08-01 DOI: 10.1016/j.amjms.2024.04.001

{"title":"Use of tumor markers in distinguishing lung adenocarcinoma-associated malignant pleural effusion from tuberculous pleural effusion","authors":"","doi":"10.1016/j.amjms.2024.04.001","DOIUrl":"10.1016/j.amjms.2024.04.001","url":null,"abstract":"<div><h3>Background</h3><p>The distinction between lung adenocarcinoma-associated malignant pleural effusion (MPE) and tuberculous pleural effusion (TPE) continues to pose a challenge. This study sought to assess the supplementary value of tumor markers in enabling a differential diagnosis.</p></div><div><h3>Methods</h3><p>Data concerning tumor markers, which included carcinoembryonic antigen (CEA), cancer antigen 125 (CA125), cancer antigen 153 (CA153), cancer antigen 724 (CA724), neuron-specific enolase (NSE), cytokeratin19 fragment (Cyfra21–1), and squamous cell carcinoma antigen (SCCA), in both serum and pleural effusion samples, were retrospectively compiled from lung adenocarcinoma-associated MPE and TPE patients. A comparative analysis of tumor marker concentrations between the two groups was performed to assess diagnostic utility, followed by a multiple logistic regression to control for confounding variables.</p></div><div><h3>Results</h3><p>While gender, serum CA125 and SCCA, and pleural effusion SCCA manifested comparability between the groups, distinctions were noted in patient age and the concentration of other tumor markers in serum and pleural effusion, which were notably elevated in the MPE group. Multiple logistic regression demonstrated a positive association between the risk of lung adenocarcinoma-associated MPE and levels of CEA and CA153 in serum and pleural effusion, as well as Cyfra21–1 in serum (<em>P</em> < 0.05). The odds ratio for CEA surpassed that of CA153 and Cyfra21–1.</p></div><div><h3>Conclusions</h3><p>CEA and CA153 in serum and pleural effusion, and Cyfra21–1 in serum emerge as biomarkers possessing supplementary diagnostic value in distinguishing lung adenocarcinoma-associated MPE from TPE. The diagnostic efficacy of CEA is superior to CA153 and Cyfra21–1. Conversely, the utility of CA125, CA724, NSE, and SCCA appears constrained.</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":"140575762","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

Massive hematuria with rashes: Type II crescentic glomerulonephritis 大量血尿伴皮疹:II型新月形肾小球肾炎。

IF 2.3 4区医学

American Journal of the Medical Sciences Pub Date : 2024-08-01 DOI: 10.1016/j.amjms.2023.11.015

引用次数: 0

Unusual endoscopic appearance of the rectum in a patient with Henoch-Schönlein purpura 一名白癜风患者直肠的异常内窥镜表现。

IF 2.3 4区医学

American Journal of the Medical Sciences Pub Date : 2024-08-01 DOI: 10.1016/j.amjms.2024.03.010

引用次数: 0

Polyarteritis nodosa with superior mesenteric artery dissection 结节性多动脉炎伴肠系膜上动脉夹层。

IF 2.3 4区医学

American Journal of the Medical Sciences Pub Date : 2024-08-01 DOI: 10.1016/j.amjms.2024.03.009

引用次数: 0

Peripheral biomarkers as a predictor of poor prognosis in severe cases of COVID-19 外周生物标志物可预测 COVID-19 重症病例的不良预后。

IF 2.3 4区医学

American Journal of the Medical Sciences Pub Date : 2024-08-01 DOI: 10.1016/j.amjms.2024.04.011

{"title":"Peripheral biomarkers as a predictor of poor prognosis in severe cases of COVID-19","authors":"","doi":"10.1016/j.amjms.2024.04.011","DOIUrl":"10.1016/j.amjms.2024.04.011","url":null,"abstract":"<div><p>We evaluated glycemia and triglyceride, hepatic, muscular, and renal damage markers, redox profile, and leptin and ghrelin hormone levels in COVID-19 patients. We also conducted statistical analysis to verify the potential of biomarkers to predict poor prognosis and the correlation between them in severe cases. We assessed glycemia and the levels of triglycerides, hepatic, muscular, and renal markers in automatized biochemical analyzer. The leptin and ghrelin hormones were assessed by the ELISA assay. Severe cases presented high glycemia and triglyceride levels. Hepatic, muscular, and renal biomarkers were altered in severe patients. Oxidative stress status was found in severe COVID-19 patients. Severe cases also had increased levels of leptin. The ROC curves indicated many biomarkers as poor prognosis predictors in severe cases. The Spearman analysis showed that biomarkers correlate between themselves. Patients with COVID-19 showed significant dysregulation in the levels of several peripheral biomarkers. We bring to light that a robust panel of peripheral biomarkers and hormones predict poor prognosis in severe cases of COVID-19 and biomarkers correlate with each other. Early monitoring of these biomarkers may lead to appropriate clinical interventions in patients infected by SARS-CoV2.</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":"140791040","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

Syndecans and diabetic complications: A narrative review 综述与糖尿病并发症：叙述性综述。

IF 2.3 4区医学

American Journal of the Medical Sciences Pub Date : 2024-08-01 DOI: 10.1016/j.amjms.2024.04.017

引用次数: 0

Association of coagulation function with the risk of in-hospital mortality in patients with severe acute respiratory distress syndrome 凝血功能与严重急性呼吸窘迫综合征患者院内死亡风险的关系。

IF 2.3 4区医学

American Journal of the Medical Sciences Pub Date : 2024-08-01 DOI: 10.1016/j.amjms.2024.04.012

{"title":"Association of coagulation function with the risk of in-hospital mortality in patients with severe acute respiratory distress syndrome","authors":"","doi":"10.1016/j.amjms.2024.04.012","DOIUrl":"10.1016/j.amjms.2024.04.012","url":null,"abstract":"<div><h3>Background</h3><p>To evaluate the association of coagulation disorder score with the risk of in-hospital mortality in acute respiratory distress syndrome (ARDS) patients.</p></div><div><h3>Methods</h3><p>In this cohort study, 7,001 adult patients with ARDS were identified from the Medical Information Mart for Intensive Care Database-IV (MIMIC-IV). Univariate and multivariate Logistic stepwise regression models were used to explore the associations of coagulation-associated biomarkers with the risk of in-hospital mortality in patients with ADRS. Restricted cubic spline (RCS) was plotted to explore the association between coagulation disorder score and in-hospital mortality of ARDS patients.</p></div><div><h3>Results</h3><p>The follow-up time for in-hospital death was 7.15 (4.62, 13.88) days. There were 1,187 patients died and 5,814 people survived in hospital. After adjusting for confounding factors, increased risk of in-hospital mortality in ARDS patients was observed in those with median coagulation disorder score [odds ratio (OR) = 1.22, 95% confidence interval (CI): 1.01–1.47) and high coagulation disorder score (OR = 1.38, 95% CI: 1.06–1.80). The results of RCS indicated that when the coagulation disorder score >2, the trend of in-hospital mortality rose gradually, and OR was >1.</p></div><div><h3>Conclusions</h3><p>Poor coagulation function was associated with increased risk of in-hospital mortality in ARDS patients. The findings implied that clinicians should regularly detect the levels of coagulation-associated biomarkers for the management of ARDS patients.</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":"140784036","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

Patterns of gastroenterology specialty referral for primary care patients with metabolic dysfunction-associated steatotic liver disease 代谢功能障碍相关性脂肪肝初级保健患者的消化道专科转诊模式。

IF 2.3 4区医学

American Journal of the Medical Sciences Pub Date : 2024-07-27 DOI: 10.1016/j.amjms.2024.07.028

John F.G. Bobo MD, Brad A. Keith MD, Justin Marsden MBA, Jingwen Zhang MS, Andrew D. Schreiner MD, MSCR

{"title":"Patterns of gastroenterology specialty referral for primary care patients with metabolic dysfunction-associated steatotic liver disease","authors":"John F.G. Bobo MD, Brad A. Keith MD, Justin Marsden MBA, Jingwen Zhang MS, Andrew D. Schreiner MD, MSCR","doi":"10.1016/j.amjms.2024.07.028","DOIUrl":"10.1016/j.amjms.2024.07.028","url":null,"abstract":"<div><h3>Background</h3><div>As metabolic dysfunction-associated steatotic liver disease (MASLD) management extends into primary care, little is known about patterns of specialty referral for affected patients. We determined the proportion of primary care patients with MASLD that received a gastroenterology (GI) consultation and compared advanced fibrosis risk between patients with and without a referral.</div></div><div><h3>Methods</h3><div>This retrospective study of electronic health record data from a primary care clinic included patients with MASLD, no competing chronic liver disease diagnoses, and no history of cirrhosis. Referral to GI for evaluation and management (E/M) any time after MASLD ascertainment was the outcome. Fibrosis-4 Index (FIB-4) scores were calculated, categorized by advanced fibrosis risk, and compared by receipt of a GI E/M referral. Logistic regression models were developed to determine the association of FIB-4 risk with receipt of a GI referral.</div></div><div><h3>Results</h3><div>The cohort included 652 patients of which 12% had FIB-4 scores (≥2.67) at high-risk for advanced fibrosis. Overall, 31% of cohort patients received a GI referral for E/M. There was no difference in the proportion of patients with high (12% vs. 12%, <em>p</em>=0.952) risk FIB-4 scores by receipt of a GI E/M referral. In adjusted logistic regression models, high-risk FIB-4 scores (OR 1.01; 95% CI 0.59 - 1.71) were not associated with receipt of a referral.</div></div><div><h3>Conclusions</h3><div>Only 30% of patients in this primary care MASLD cohort received a GI E/M referral during the study period, and those patients with a referral did not differ by FIB-4 advanced fibrosis risk.</div></div>","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141794461","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