The American journal of the medical sciences最新文献

{"title":"COVID-19 in Retrospect: Public Health Lessons from a Global Crisis.","authors":"Dale W Bratzler","doi":"10.1016/j.amjms.2025.10.008","DOIUrl":"https://doi.org/10.1016/j.amjms.2025.10.008","url":null,"abstract":"<p><p>The COVID-19 pandemic, emerging in late 2019, rapidly evolved into a global health crisis of unprecedented scale. Initially marked by widespread transmission and severe illness, the pandemic overwhelmed healthcare systems, disrupted economies, and exposed deep-rooted inequalities. Over 775 million cases and an estimated 18-33 million global deaths were recorded by 2024. The crisis illuminated critical vulnerabilities in pandemic preparedness, healthcare infrastructure, and public health communication. Key lessons included the need for resilient supply chains, robust data systems, equitable healthcare access, and sustained investment in public health. Misinformation significantly hindered response efforts, underscoring the importance of aligned scientific and public messaging. The pandemic also triggered debates over civil liberties and public health authority. While rapid vaccine development was a major achievement, the overall response highlighted systemic gaps. These insights offer a roadmap for improving future pandemic responses and safeguarding global health security.</p>","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145338405","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":"Multidrug-resistant Gram-negative Organisms: A Primer on Mechanisms of Resistance and Emerging Therapies for the non-Infectious Diseases Clinician.","authors":"R Alfonso Hernandez Acosta, Max W Adelman, Jesse T Jacob, William R Miller","doi":"10.1016/j.amjms.2025.10.009","DOIUrl":"https://doi.org/10.1016/j.amjms.2025.10.009","url":null,"abstract":"<p><p>The emergence of antibiotic resistance is a leading challenge in the treatment of infections due to Gram-negative organisms. Increasing rates of resistance are commonly seen in healthcare-associated infections, and recently introduced and emerging treatment options require an understanding of the underlying resistance mechanisms for effective use. This review covers the mechanism, identification, and treatment of resistant Gram-negative organisms including extended spectrum β-lactamase (ESBL) producing, AmpC producing, and carbapenem resistant Enterobacterales, Pseudomonas aeruginosa with difficult-to-treat resistance, and carbapenem-resistant Acinetobacter baumannii. It is designed to help the non-infectious diseases clinician to understand the changing landscape in the treatment of drug-resistant infections.</p>","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145338391","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":"Infectious Complications of Chimeric Antigen Receptor T Cell Therapy and Bispecific Antibodies - A Review.","authors":"Bradley Dye, Daniel Gromer, Bibi Maryam, Emily A Siegrist, Joseph Sassine","doi":"10.1016/j.amjms.2025.10.007","DOIUrl":"https://doi.org/10.1016/j.amjms.2025.10.007","url":null,"abstract":"<p><p>Chimeric antigen receptor (CAR) T cell therapy has shifted the therapeutic landscape of hematological malignancies in the last decade, and bispecific antibodies (BsAb) are an emerging treatment for this patient population. Immunosuppression associated with these therapies can lead to a variety of infectious complications. In this narrative review, we explore the epidemiology, risk factors and prevention of bacterial, viral and fungal infections after CAR T cell and BsAb therapy.</p>","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145338389","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":"In Memoriam: Richard W McCallum.","authors":"","doi":"10.1016/j.amjms.2025.10.005","DOIUrl":"https://doi.org/10.1016/j.amjms.2025.10.005","url":null,"abstract":"","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145319086","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":"The Effects of Lifestyle Factors on Primary Biliary Cholangitis Ascertained by Two-Sample Mendelian Randomization.","authors":"Gang Shen, Hengchang Sun, Xiaoling Guan, Yaqiong Chen, Lin Wang, Xinhua Li, Jiao Gong, Bo Hu","doi":"10.1016/j.amjms.2025.10.004","DOIUrl":"https://doi.org/10.1016/j.amjms.2025.10.004","url":null,"abstract":"<p><strong>Background: </strong>Primary biliary cholangitis (PBC) is a chronic liver disease leading to irreversible cirrhosis and liver failure. This study aims to evaluate the relationships between genetically predicted nine lifestyle factors and PBC by Mendelian randomization (MR).</p><p><strong>Methods: </strong>Genome-wide association study (GWAS) data were utilized to identify genetic variants significantly associated with specific lifestyle factors, employing a stringent significance threshold of P-value< 5 × 10^-8 and linkage disequilibrium [LD] r² <0.01 with a clumping distance cutoff of 5000 kb. Subsequently, univariable and multivariable MR analyses were conducted, where the inverse variance weighted (IVW) method was considered as the primary analytical approach and then followed by sensitivity analysis.</p><p><strong>Results: </strong>Non-oily fish intake was causally associated with an increased risk of PBC, with an odds ratio (OR) of 578 (95% confidence interval (CI) 24.17-1.39 × 10⁴). Conversely, the intake of oily fish did not demonstrate a significant decrease in the risk of PBC (P>0.05). There were suggestive associations observed between bread intake and household income (0.0056<P<0.05). Furthermore, multivariable MR revealed that only non-oily fish intake remained statistically significant (OR=152, 95%CI=1.51-1.55 × 10⁴, P=0.0327).</p><p><strong>Conclusion: </strong>Our findings underscore the causal relationship between non-oily fish intake and an elevated risk of PBC, as ascertained through both univariable and multivariable MR analyses. These findings hold potential clinical implications for the prevention of PBC.</p>","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314383","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":"Trends in hypertensive renal disease with renal failure-related mortality among gender ethnicity and states in the United States from 1999-2020.","authors":"Muhammad Shaheer Bin Faheem, Faiza Ikram, Muhammad Saad Iqbal, Muhammad Owais Mazhar, Hurmat Fatima, Awais Akhtar, Uzair Irfan, Muhammad Omar Ashfaq, Ahmed Faraz, Raheel Ahmed","doi":"10.1016/j.amjms.2025.10.003","DOIUrl":"10.1016/j.amjms.2025.10.003","url":null,"abstract":"<p><strong>Background: </strong>Hypertensive renal disease impacts approximately 753 million individuals worldwide each year. This study evaluates trends in hypertensive renal disease mortality from 1999 to 2020 in the US, focusing on disparities related to gender, race, and urbanization by examining the Age-Adjusted Mortality Rate (AAMR) to inform targeted intervention and improve outcomes.</p><p><strong>Methods: </strong>The CDC WONDER database analyzed hypertensive renal disease with renal-failure-related mortality from 1999 to 2020, calculating mortality rates and a 95 % confidence interval to assess national trends.</p><p><strong>Results: </strong>Throughout the study period, males constantly exhibited a higher Age-Adjusted Mortality Rates (AAMR) for hypertensive renal disease with renal-failure-related mortality 148.92 (95 % CI: 148.37 - 149.48) than females 106.11 (95 % CI: 105.73 - 106.49). African American individuals exhibited the highest overall AAMR at 286.29 (95 % CI: 284.68 - 287.9), starting at 186.23 in 1999 (95 % CI: 179.34 - 193.13) and increasing to 529.72 in 2020 (APC: 5.27; 95 % CI: 520.77 - 538.67). From 1999 to 2020, AAMR rose in metropolitan areas from 197.57 (95 % CI: 187.88-207.26) to 1112.12 (APC: 10.00; 95 % CI: 1093.39-1130.85), and in non-metropolitan areas from 97.35 (95 % CI: 90.63-104.08) to 643.06 (APC: 11.81; 95 % CI: 627.76-658.37).AAMRs varied significantly by state, from 61.23 (95 % CI: 59.29-63.16) in Connecticut to 225.06 (95 % CI: 214.96-235.16) in the District of Columbia.</p><p><strong>Conclusions: </strong>From 1999 to 2020, the mortality rate from hypertensive-related renal diseases rose uncertainly, with a sharp incline starting from 2013 to a sudden surge in 2020 due to COVID-19-related renal complications. Higher deaths were observed in males, African American ethnicity, and individuals living in non-metropolitan areas. Addressing these problems requires a multifactorial public health approach focusing on early detection, equitable care, and targeted intervention to reduce disease burden.</p>","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145282458","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":"Can health literacy reduce the risk of chronic complications in diabetic patients?","authors":"Betul Erismis, Nesibe Simsekoglu, Merve Feyza Demir Gurdal, Neziha Erken, Ozge Pasin, Enes Seyda Sahiner","doi":"10.1016/j.amjms.2025.10.002","DOIUrl":"10.1016/j.amjms.2025.10.002","url":null,"abstract":"<p><strong>Objectives: </strong>Health literacy (HL) is a key determinant of health outcomes, particularly in managing chronic conditions like diabetes mellitus (DM). This study investigates Hl levels in diabetic patients and examines its association with chronic complications.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with 207 diabetic patients between April and July 2024. HL was assessed using the Turkey Health Literacy Scale, categorizing patients into four levels: inadequate, problematic, adequate, and excellent. Demographic data, laboratory results, and microvascular/macrovascular complications were analyzed using non-parametric statistical tests.</p><p><strong>Results: </strong>The mean HL score was 29.83, and 32.8 % of participants experiencing chronic microvascular complications. HL levels were significantly associated with education, gender, and occupation but showed no direct correlation with chronic complications or HbA1c levels. However, patients with lower HL had higher rates of microalbuminuria and poor glycemic control.</p><p><strong>Conclusions: </strong>Although HL was not directly linked to chronic DM complications, inadequate HL may contribute to a higher risk of specific complications, such as diabetic nephropathy. Addressing HL through targeted interventions can enhance diabetes self-management and reduce complication risks.</p><p><strong>Practice implications: </strong>Routine HL assessments and personalized education strategies-incorporating digital tools and community support-could enhance patient outcomes and alleviate healthcare burdens. Policymakers and researchers should prioritize HL in chronic disease management strategies.</p>","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234237","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":"Targeting the ROS-ferroptosis axis: A clinical perspective on oxidative stress management in systemic lupus erythematosus.","authors":"Xiaoyan Xu, Wenfeng Gao, Lei Pang, Yiming Chen, Shuijing Liang, Xiaodong Wang","doi":"10.1016/j.amjms.2025.10.001","DOIUrl":"10.1016/j.amjms.2025.10.001","url":null,"abstract":"<p><p>Systemic lupus erythematosus (SLE) is a classic autoimmune condition marked by inflammation in multiple organs and a malfunctioning immune system. Despite advances in immunosuppressive therapies, patients frequently experience relapses, organ damage, and significant quality-of-life impairment. Recent findings indicate that ferroptosis, a form of regulated cell death dependent on iron, has a substantial impact on the progression of lupus. However, the precise molecular interplay between ROS generation, iron metabolism dysregulation, and immune cell dysfunction in SLE remains incompletely understood. This review analyzes the ROS-ferroptosis axis in SLE, highlighting its role in promoting pathological immune responses and worsening tissue injury. It also discusses targeted therapies like iron chelators and GPX4 agonists, which show promise in preclinical models and early trials, identifies actionable targets, evaluates their translational potential for precision therapies, and bridges preclinical mechanisms with clinical applications to address unmet SLE management needs.</p>","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234365","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":"Osteoimmunology: the little niche with the big impact.","authors":"Shivmurat Yadav, Jyoti Yadav, Derrick Jones, Mary Beth Humphrey","doi":"10.1016/j.amjms.2025.09.014","DOIUrl":"10.1016/j.amjms.2025.09.014","url":null,"abstract":"<p><p>Osteoimmunology, which emerged in the early 2000s, was paradigm-shifting in its integration of immunology and skeletal research, recognizing the pivotal role of immunoreceptors on preosteoclasts, immune cells, and proinflammatory cytokines contributing to inflammatory bone remodeling. Numerous immunoreceptors and key signaling pathways were defined that regulate osteoclastogenesis. A dynamic interplay between lymphocytes and osteoclasts was found to be fundamental to maintaining bone homeostasis and contributing to pathological bone resorption in inflammatory arthritis or malignant metastasis. Osteoimmunology has expanded to include crosstalk between osteoclasts and osteoblasts, the role of bone marrow stromal cells in maintaining the hematopoietic stem cell niche, and the influence of the microbiome on lymphocytes that drive bone remodeling. Deciphering the intricate mechanisms that govern the immune system's regulation of bone remodeling remains a central objective in osteoimmunology, offering promising avenues for the development of targeted therapeutic strategies aimed at restoring skeletal equilibrium.</p>","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234269","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":"Relationship between depression and chronic liver disease: Potential role of antidepressants in modulating liver fibrosis.","authors":"Ahmad Basil Nasir, Spyridon Zouridis, Patricia Aspichueta, Paul Manka, Wing-Kin Syn","doi":"10.1016/j.amjms.2025.07.018","DOIUrl":"10.1016/j.amjms.2025.07.018","url":null,"abstract":"<p><p>Depression is a frequent comorbidity in chronic liver disease (CLD), including Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), viral hepatitis, autoimmune hepatitis (AIH), primary sclerosing cholangitis (PSC), primary biliary cholangitis (PBC), hemochromatosis, and Wilson's disease. It is associated with worse outcomes, accelerated disease progression, increased hospitalizations, and higher mortality. While antidepressants are commonly prescribed, their effects on liver disease, particularly on liver fibrosis, remain underexplored. This narrative review examines the relationship between depression, CLD, and antidepressants through a literature review of studies published between 2010 and 2024. Some evidence suggests that antidepressants may have antifibrotic properties, as seen in pulmonary fibrosis, but liver-specific data are limited. Understanding their potential role in both mental health and liver disease management could improve patient outcomes. However, significant research gaps remain, and further clinical trials are needed to determine whether antidepressants influence liver fibrosis, disease progression, and overall prognosis in CLD.</p>","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226587","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}