American journal of medicine open最新文献

{"title":"What are the attitudes of medical students and housestaff towards health advocacy? A physician-led voter registration initiative and health advocacy survey","authors":"Robert J DeGrazia Jr ,&nbsp;Serena Ogunwole ,&nbsp;Ting-Jia Lorigiano ,&nbsp;Jessica Bienstock ,&nbsp;Craig Evan Pollack","doi":"10.1016/j.ajmo.2022.100023","DOIUrl":"10.1016/j.ajmo.2022.100023","url":null,"abstract":"<div><h3>Background</h3><p>Compared to the general population, physicians have been shown to be less engaged in civic participation and less likely to vote. However, perspectives of current trainees on health advocacy remain under-explored.</p></div><div><h3>Objective</h3><p>To investigate perspectives on a physician led voter registration initiative and identify current beliefs of physicians in training and medical students regarding physician health advocacy.</p></div><div><h3>Design</h3><p>Cross sectional survey performed at a single urban academic center.</p></div><div><h3>Participants</h3><p>A total of 366 medical students, residents, and fellows voluntarily participated in the survey out of a total of 1,719 available (21% response rate).</p></div><div><h3>Main Measures</h3><p>We examined the current perceptions surrounding health advocacy among medical students and physicians in training and how this was impacted by the COVID-19 pandemic. Responses were analyzed using Chi-square analysis and logistic regression.</p></div><div><h3>Key Results</h3><p>The voter registration code was scanned 131 times prior to the 2020 Presidential elections. Barriers to hospital-based voter registration included lack of time, lack of fit into the workflow and forgetting to ask. Over half of internal medicine-based residents and fellows (51%) and medical students (63%) agreed that physicians should be involved in helping patients register to vote compared to 34% of surgical-based trainees. A large majority (87%) indicated that the COVID-19 pandemic made it more necessary for physicians to be involved in politics.</p></div><div><h3>Conclusion</h3><p>A high proportion of medical students and housestaff across specialties report an obligation to be involved in health advocacy, though there were differing views towards direct involvement in voter registration.</p></div>","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667036422000188/pdfft?md5=f725c9319fe929796d64a4b675c85a35&pid=1-s2.0-S2667036422000188-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45142892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Association between electronic cigarette use and fragility fractures among US adults” contains significant errors","authors":"Nantaporn Plurphanswat,&nbsp;Brad Rodu","doi":"10.1016/j.ajmo.2022.100017","DOIUrl":"https://doi.org/10.1016/j.ajmo.2022.100017","url":null,"abstract":"","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667036422000115/pdfft?md5=ada383ac9968ecebd2c12196174664bd&pid=1-s2.0-S2667036422000115-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136709716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gun-related mortality in children- Seeing past Geography","authors":"S. Chipkin","doi":"10.1016/j.ajmo.2022.100021","DOIUrl":"https://doi.org/10.1016/j.ajmo.2022.100021","url":null,"abstract":"","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48633831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular risk, fatty liver disease, glucose and insulin curve among prediabetes phenotypes in Peruvian population","authors":"Jesus Rocca-Nación ,&nbsp;Maria Calderon","doi":"10.1016/j.ajmo.2022.100007","DOIUrl":"10.1016/j.ajmo.2022.100007","url":null,"abstract":"<div><h3>Aims</h3><p>To describe the cardiovascular risks, fatty liver disease, and glucose and insulin curve among prediabetes phenotypes (PPh) in Peruvian population.</p></div><div><h3>Methods</h3><p>A study was carried out using a secondary database of a series of patients with identified risk factors for diabetes mellitus type 2 in one clinic in Lima, Peru. Patients were divided according with the OGTT in impaired glucose 2h or IGT(Pph1), impaired fasting glucose or IFG(Pph3) or both(Pph2).</p></div><div><h3>Results</h3><p>259 patients were identified for analysis, 149 of whom had normal OGTT, 94 had prediabetes (36.3%), and 16 diabetes (6.2%). We found that 37(39.4%), 37(39.4%) and 20(21.2%) presented Pph1, Pph-2 and Pph-3 respectively. Most of the cardiovascular risks and hepatic function comparison showed no difference in our study sample groups. However, we found that Pph2 showed significantly higher abnormalities in HDL-c, triglycerides, hepatic steatosis, and HOMA-IR compared with normal OGTT group (<em>p</em> &lt; 0.05). Interestingly, this difference was not seen with the other phenotypes. Also, hepatic steatosis was higher in Pph2 compared to Pph3 (<em>p</em> &lt; 0.05). HOMA-IR was high in Phenotype 2 compared with Phenotype 1. Regarding hepatic steatosis, this was high in all prediabetes phenotypes, however we found this to be of statistical significance in Pph2 compared to Pph3 (<em>p</em> &lt; 0.01).</p></div><div><h3>Conclusions</h3><p>In general, prediabetes phenotypes show a similar association with cardiovascular risk factors and hepatic steatosis, however, Pph2 show more differences in specific comparisons. We believe that this study is a starting point for further investigation to understand prediabetes in Peruvian population and be able to improve disease risk stratification.</p></div>","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667036422000024/pdfft?md5=d609e9dac459a5c4e943f13b43693efb&pid=1-s2.0-S2667036422000024-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43818415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute but not chronic heart failure is associated with higher mortality among patients hospitalized with pneumonia: An analysis of a nationwide database","authors":"Essa Hariri ,&nbsp;Niti G. Patel ,&nbsp;Elias Bassil ,&nbsp;Milad Matta ,&nbsp;Pei-Chun Yu ,&nbsp;Quinn R. Pack ,&nbsp;Michael B. Rothberg","doi":"10.1016/j.ajmo.2022.100013","DOIUrl":"10.1016/j.ajmo.2022.100013","url":null,"abstract":"<div><h3>Background</h3><p>Among patients admitted for pneumonia, heart failure (HF) is associated with worse outcomes. It is unclear whether this association is due to acute HF exacerbations, complex medical management, or chronic co-morbid conditions.</p></div><div><h3>Methods</h3><p>This is a retrospective cohort study of patients admitted between July 2010 and June 2015 at 651 US hospitals with a principal diagnosis of either pneumonia or secondary diagnosis of pneumonia with a primary diagnosis of respiratory failure or sepsis. Comorbidities were identified by ICD-9 codes and medical management by daily charge codes. Patients were categorized according to the presence and acuity of admission diagnosis of HF. In-hospital mortality was the primary outcome. Secondary outcomes included length of stay, hospital cost, ICU admission, use of mechanical ventilation, vasopressors and inotropes. Logistic regression was used to study the association of outcomes with presence and acuity of HF.</p></div><div><h3>Results</h3><p>Of 783,702 patients who met inclusion criteria, 212,203 (27%) had a diagnosis of HF. Of these, 56,306 (26.5%) had acute while 48,188 (22.7%) had chronic HF on admission; 51% had a diagnosis of unspecified HF. In multivariable-adjusted models, having any HF was associated with increased mortality (OR 1.35 [1.33 - 1.38]) compared to those without HF; increased mortality was associated with acute HF (OR 1.19 [1.15 - 1.22]) but not chronic HF (OR 0.92 [0.89 - 0.96]).</p></div><div><h3>Conclusion</h3><p>The worse outcomes for pneumonia patients with HF appear due to acute HF exacerbations. Adjustment for HF without accounting for chronicity could lead to biased prognostic and billing estimates.</p></div>","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/83/8c/nihms-1812932.PMC9211036.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40225620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peak performance: Putting type 1 diabetes management recommendations for athletes to the test","authors":"Bradley Grightmire,&nbsp;Wajd Alkabbani,&nbsp;John-Michael Gamble","doi":"10.1016/j.ajmo.2022.100011","DOIUrl":"10.1016/j.ajmo.2022.100011","url":null,"abstract":"<div><h3>Background</h3><p>Athletes with type 1 diabetes (T1D) face unique challenges to maintain optimal glucose levels and therefore require tailored guidance from their healthcare providers. Herein, we aim to summarize and compare recommendations targeted at T1D management in athletes in commonly used clinical practice guidelines and topical position statements. The objective is to assess if the available recommendations are comprehensive enough for athletes to apply to high-performance sport.</p></div><div><h3>Methods</h3><p>From seven clinical practice guidelines and positions statements, we identified recommendations relevant to athletes with T1D, based on a specific hierarchy. For included recommendations, we extracted relevant information including the year of publication, author(s), chapter name or number, text for the recommendation, and level of evidence. Based, on the clinical topic covered, we grouped included recommendations to five themes.</p></div><div><h3>Results</h3><p>We screened a total of 126 recommendations, of which 60 recommendations were included. The National Athletic Trainers’ Association provided the highest number of recommendations relevant to athletes with T1D (<em>n</em> = 27). Insulin modifications was the most covered clinical theme (<em>n</em> = 18). The 2018 Diabetes Canada and 2021 American Diabetic Association guidelines linked recommendations directly with levels and grades of evidence. None of the recommendations had level 1 or grade A evidence. Three recommendations from Diabetes Canada reported level 2, grade B evidence. American Diabetic Association reported 1 recommendation with grade B evidence, and 2 recommendations with grade C evidence.</p></div><div><h3>Conclusions</h3><p>There is an opportunity for expansion of clinical practice guidelines to increase the depth and breadth of recommendations for high performance athletes with T1D.</p></div>","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667036422000061/pdfft?md5=0f048b765c6758b84e2e429978c7013b&pid=1-s2.0-S2667036422000061-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42323130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological trends of youth firearm mortality in the U.S. States, 2010-2019","authors":"James H. Price ,&nbsp;Jagdish Khubchandani","doi":"10.1016/j.ajmo.2022.100006","DOIUrl":"https://doi.org/10.1016/j.ajmo.2022.100006","url":null,"abstract":"","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667036422000012/pdfft?md5=2dc29d4b290e63e26c8055013fabd7a4&pid=1-s2.0-S2667036422000012-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136434013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pitfalls in the use of mobile wireless devices in healthcare: Distraction, errors, procrastination, and burnout","authors":"Nidhi Gupta","doi":"10.1016/j.ajmo.2022.100010","DOIUrl":"10.1016/j.ajmo.2022.100010","url":null,"abstract":"","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266703642200005X/pdfft?md5=6d7a3bc968d7588ff86ec779641b54bc&pid=1-s2.0-S266703642200005X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48118692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stable high-sensitivity cardiac troponin T levels and the association with frailty and prognosis in patients with chest pain","authors":"Love S. Strandberg ,&nbsp;Andreas Roos ,&nbsp;Martin J. Holzmann","doi":"10.1016/j.ajmo.2021.100001","DOIUrl":"10.1016/j.ajmo.2021.100001","url":null,"abstract":"<div><h3>Background</h3><p>Chronic myocardial injury is defined by stable high-sensitivity cardiac troponin (hs-cTn) levels above the 99th percentile value, which may be a sign of a biologically aged heart. This study investigated the association between frailty and chronic myocardial injury.</p></div><div><h3>Methods</h3><p>In a cohort of patients with chest pain and stable hs-cTnT levels measured 2011–2014, we included all patients who were assessed by two scoring systems measuring frailty. Adjusted odds ratios (ORs) were calculated to estimate the risk of frailty at different hs-cTnT levels (referent: hs-cTnT ≤ 14 ng/l). Cox regression was used to estimate risks of death and cardiovascular events in relation to frailty status and hs-cTnT levels (referent: non-frail and hs-cTnT ≤ 14 ng/l).</p></div><div><h3>Results</h3><p>A total of 979 patients were included, of whom 269 (27%) had chronic myocardial injury. The risk of being frail was almost four times higher in patients with chronic myocardial injury, compared with patients in the reference group (hs-cTnT ≥ 30 ng/l: OR: 3.69, 95% CI: 2.02-6.76). During a follow-up of 4.3 years, 275 (28%) patients died. Mortality risks increased with increasing hs-cTnT levels and degree of frailty, being increased four-fold in frail patients with hs-cTnT levels ≥ 30 ng/l (HR: 4.07, 95% CI: 2.42-6.86).</p></div><div><h3>Conclusions</h3><p>Stable hs-cTnT levels are associated with the degree of frailty, and frailty measurements could help to identify patients with stable hs-cTnT levels who are at a high risk of death. The findings support the hypothesis that chronic myocardial injury could be a marker of a biologically aged heart.</p></div>","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667036421000017/pdfft?md5=b102ca9465ae7abe3e07a50f0465bb86&pid=1-s2.0-S2667036421000017-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41254022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between electronic cigarette use and fragility fractures among US adults","authors":"Dayawa D. Agoons ,&nbsp;Batakeh B. Agoons ,&nbsp;Kelechi E. Emmanuel ,&nbsp;Firdausi A. Matawalle ,&nbsp;Jessica M. Cunningham","doi":"10.1016/j.ajmo.2021.100002","DOIUrl":"10.1016/j.ajmo.2021.100002","url":null,"abstract":"<div><h3>Background</h3><p>The popularity of electronic cigarette (e-cigarette) use continues to rise in the United States. While conventional cigarette smoking is an established risk factor for osteoporosis and osteoporotic fracture, the effects of e-cigarette use on bone health are unknown. We aimed to examine the association between e-cigarette use and fragility fractures.</p></div><div><h3>Research Design and Methods</h3><p>We pooled 2017–2018 data from the National Health and Nutrition Examination Survey (NHANES). We included men and women with complete information on key variables. E-cigarette use was categorized as either never or ever users. Ever users were further classified as former and current users. Fragility fracture was defined as a composite of self-reported fracture of the hip, spine or wrist which resulted from minimal trauma such as a fall from standing height or less.</p></div><div><h3>Results</h3><p>Of 5569 participants, there were 4519 (81.2%) never e-cigarette users, 1050 (18.8%) ever e-cigarette users, and 444 (8.0%) with self-reported fragility fracture. In adjusted models, ever e-cigarette users had a 46% higher prevalence of self-reported fragility fractures compared to never users (aPR: 1.46, 95% CI: 1.12, 1.89). We also observed a higher prevalence of fragility fractures among former and current e-cigarette users compared to never users (aPR: 1.89, 95% CI: 1.44, 2.48 and aPR: 1.77, 95% CI: 1.04, 3.02 respectively).</p></div><div><h3>Conclusion</h3><p>E-cigarette use was associated with a higher prevalence of self-reported fragility fracture. These findings suggest that e-cigarette use may be harmful to bone health. These data highlight the critical need for longitudinal studies exploring the potential effect(s) of e-cigarette use on bone health.</p></div>","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667036421000029/pdfft?md5=fc7a3b82123aa153b8e27bda89a9cc62&pid=1-s2.0-S2667036421000029-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42033419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}