American Journal of the Medical Sciences最新文献

{"title":"Polyarteritis nodosa with superior mesenteric artery dissection","authors":"","doi":"10.1016/j.amjms.2024.03.009","DOIUrl":"10.1016/j.amjms.2024.03.009","url":null,"abstract":"","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":"368 2","pages":"Pages e19-e20"},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140095463","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":"Anesthetic challenges in Curschmann Steinert's disease (DM1): The importance of respiratory assessment","authors":"María Fernanda García Aguilera MD, PhD , Carlos Manterola MD, PhD , Nayely García-Méndez MD, PhD","doi":"10.1016/j.amjms.2024.07.033","DOIUrl":"10.1016/j.amjms.2024.07.033","url":null,"abstract":"","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":"368 6","pages":"Pages 679-680"},"PeriodicalIF":2.3,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861961","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":"Iron metabolism biomarkers: Linking anemia and acute exacerbations in COPD patients","authors":"Yakun Liu M.Med , Jinlong Gao M.Med , Xiaoling Wang M.Med , Zhen Yang M.Med , Xinhua Wang M.Med , Yi Zhao M.Med","doi":"10.1016/j.amjms.2024.07.034","DOIUrl":"10.1016/j.amjms.2024.07.034","url":null,"abstract":"","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":"368 6","pages":"Pages 681-684"},"PeriodicalIF":2.3,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861963","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":"Patterns of gastroenterology specialty referral for primary care patients with metabolic dysfunction-associated steatotic liver disease","authors":"John F.G. Bobo MD,&nbsp;Brad A. Keith MD,&nbsp;Justin Marsden MBA,&nbsp;Jingwen Zhang MS,&nbsp;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":"368 5","pages":"Pages 455-461"},"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}

{"title":"COVID-19 associated cutaneous polyarteritis nodosa","authors":"Milena Mimica MD. ,&nbsp;Eddy Mora MD. ,&nbsp;Loreto Massardo MD.","doi":"10.1016/j.amjms.2024.07.026","DOIUrl":"10.1016/j.amjms.2024.07.026","url":null,"abstract":"","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":"368 6","pages":"Pages e67-e68"},"PeriodicalIF":2.3,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141736228","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":"COPD overlap conditions: Clinical and therapeutic implications","authors":"Abdullah Jarrah MD ,&nbsp;Mohammed T Awad MD, MPH ,&nbsp;Cassondra Cramer-Bour MD ,&nbsp;Ayman O. Soubani MD","doi":"10.1016/j.amjms.2024.07.023","DOIUrl":"10.1016/j.amjms.2024.07.023","url":null,"abstract":"<div><div>Chronic Obstructive Pulmonary Disease (COPD) is a complex pulmonary condition characterized by chronic airflow limitation. Within the spectrum of COPD, distinct overlap conditions exist, including Asthma-COPD Overlap (ACO), COPD-Obstructive Sleep Apnea (COPD-OSA), Combined Pulmonary Fibrosis and Emphysema (CPFE), and Bronchiectasis-COPD Overlap (BCO). This review provides a comprehensive overview of the clinical and therapeutic implications of these conditions, highlighting the differences in complications compared with COPD alone in addition to the diagnostic challenges of identifying these conditions. Therapeutically tailored approaches are necessary for COPD overlap conditions considering the unique complications that may arise. Optimal pharmacological management, disease-specific interventions, and comprehensive patient-centered care are crucial components of treatment strategies. This review provides insights for healthcare professionals by enhancing their understanding and management of these conditions. This emphasizes the importance of accurate diagnosis and individualized treatment plans, considering the specific complications associated with each COPD overlap condition.</div></div>","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":"368 6","pages":"Pages 674-678"},"PeriodicalIF":2.3,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141728428","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 machine learning approach for phenotyping acute decompensated pulmonary hypertension patients admitted to the ICU","authors":"Marcos Vinicius Fernandes Garcia MD, PhD ,&nbsp;Rogerio Souza MD, PhD ,&nbsp;Pedro Caruso MD, PhD","doi":"10.1016/j.amjms.2024.07.022","DOIUrl":"10.1016/j.amjms.2024.07.022","url":null,"abstract":"","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":"368 5","pages":"Pages 544-547"},"PeriodicalIF":2.3,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141728427","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":"Dyspnea and long COVID patients","authors":"Kenneth Nugent MD,&nbsp;Gilbert Berdine MD","doi":"10.1016/j.amjms.2024.07.024","DOIUrl":"10.1016/j.amjms.2024.07.024","url":null,"abstract":"<div><p>Patients with prior COVID-19 infections often develop chronic post-COVID symptoms, such as fatigue and dyspnea. Some patients have residual pulmonary disorders with abnormal pulmonary function tests and/or chest radiographs to explain their dyspnea. However, other patients appear to have dyspnea that is out of proportion to any measurable change in lung function. Some of these patients have abnormal cardiopulmonary exercise testing with definite cardiac or respiratory limits. However, others have normal cardiopulmonary exercise testing based on VO₂ measurement but pronounced dyspnea during this testing. These patients often have abnormal respiratory patterns, referred to as dysfunctional breathing, with irregular and variable respiratory rates and/or tidal volumes. Consequently, their control of breathing is impaired, and this may represent residual effects from prior COVID-19 infection involving the central nervous system. Alternatively, patients may have acquired “a memory” of respiratory symptoms during their infection which persists post-infection. These patients should participate in pulmonary rehabilitation and breathing retraining.</p></div>","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":"368 4","pages":"Pages 399-404"},"PeriodicalIF":2.3,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141728459","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":"Monitor-related changes consistent with paradoxical pulse","authors":"Hiroki Matsuura MD ,&nbsp;Masayuki Kishida MD, PhD","doi":"10.1016/j.amjms.2024.07.014","DOIUrl":"10.1016/j.amjms.2024.07.014","url":null,"abstract":"","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":"368 6","pages":"Page e72"},"PeriodicalIF":2.3,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141690841","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 of estimated plasma volume with new onset acute kidney injury in hospitalized COVID-19 patients","authors":"Shahin Isha MBBS, MD ,&nbsp;Prasanth Balasubramanian MBBS, MD ,&nbsp;Lekhya Raavi MBBS, MD ,&nbsp;Abby J. Hanson BS ,&nbsp;Anna Jenkins BS ,&nbsp;Parthkumar Satashia MBBS, MD ,&nbsp;Arvind Balavenkataraman MBBS, MD ,&nbsp;Iván A. Huespe MD ,&nbsp;Aysun Tekin MD ,&nbsp;Vikas Bansal MBBS, MPH ,&nbsp;Sean M. Caples DO, MS ,&nbsp;Syed Anjum Khan MD ,&nbsp;Nitesh K. Jain MBBS ,&nbsp;Abigail T. LaNou MD ,&nbsp;Rahul Kashyap MBBS, MBA ,&nbsp;Rodrigo Cartin-Ceba MD ,&nbsp;Bhavesh M. Patel MD ,&nbsp;Houssam Farres MD ,&nbsp;Scott A. Helgeson MD ,&nbsp;Ricardo Diaz Milian MD ,&nbsp;Devang K. Sanghavi MBBS, MD","doi":"10.1016/j.amjms.2024.07.018","DOIUrl":"10.1016/j.amjms.2024.07.018","url":null,"abstract":"<div><h3>Purpose</h3><div>To explore the association of estimated plasma volume (ePV) and plasma volume status (PVS) as surrogates of volume status with new-onset AKI and in-hospital mortality among hospitalized COVID-19 patients.</div></div><div><h3>Materials and methods</h3><div>We performed a retrospective multi-center study on COVID-19-related ARDS patients who were admitted to the Mayo Clinic Enterprise health system. Plasma volume was calculated using the formulae for ePV and PVS, and longitudinal analysis was performed to find the association of ePV and PVS with new-onset AKI during hospitalization as the primary outcome and in-hospital mortality as a secondary outcome.</div></div><div><h3>Results</h3><div>Our analysis included 7616 COVID-19 patients with new-onset AKI occurring in 1365 (17.9%) and a mortality rate of 25.96% among them. A longitudinal multilevel multivariate analysis showed both ePV (OR 1.162; 95% CI 1.048–1.288, <em>p</em>=0.004) and PVS (OR 1.032; 95% CI 1.012–1.050, <em>p</em>=0.001) were independent predictors of new onset AKI. Higher PVS was independently associated with increased in-hospital mortality (OR 1.038, 95% CI 1.007–1.070, <em>p</em>=0.017), but not ePV (OR 0.868, 95% CI 0.740–1.018, <em>p</em>=0.082).</div></div><div><h3>Conclusion</h3><div>A higher PVS correlated with a higher incidence of new-onset AKI and worse outcomes in our cohort of hospitalized COVID-19 patients. Further large-scale and prospective studies are needed to understand its utility.</div></div>","PeriodicalId":55526,"journal":{"name":"American Journal of the Medical Sciences","volume":"368 6","pages":"Pages 589-599"},"PeriodicalIF":2.3,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617803","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}