The American journal of the medical sciences最新文献

{"title":"Corrigendum to \"COVID-19 vaccination likelihood among federally qualified health center patients: Lessons learned for future health crises\" [Am J Med Sci. 366 (2023) 321-329].","authors":"Erin Peacock, Leslie S Craig, Michelle Wilson, LaKeisha Williams, Sara Al Dahir, Wan Tang, Alecia Cyprian, MarkAlain Dery, Darie Gilliam, Diem Nguyen, Kabrina Smith, Matthew Valliere, Shondra Williams, Gary Wiltz, Keith Winfrey, Terry Davis, Connie Arnold, Katherine Theall, Daniel Sarpong, Marie Krousel-Wood","doi":"10.1016/j.amjms.2025.07.016","DOIUrl":"https://doi.org/10.1016/j.amjms.2025.07.016","url":null,"abstract":"","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700796","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":"Corrigendum to \"Clinical trial participation among underserved communities: Insights from the Louisiana Community Engagement Alliance\" [Am J Med Sci. 366 (2023): 254-262].","authors":"Leslie S Craig, Daniel F Sarpong, Erin M Peacock, Katherine P Theall, LaKeisha Williams, Sara Al-Dahir, Terry C Davis, Connie L Arnold, Allie Williams, Tynesia Fields, Michelle Wilson, Marie Krousel-Wood","doi":"10.1016/j.amjms.2025.07.015","DOIUrl":"https://doi.org/10.1016/j.amjms.2025.07.015","url":null,"abstract":"","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700795","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":"Corrigendum to \"Associations between psoriasis, psoriatic arthritis and gout or hyperuricemia: A systematic review and meta-analysis\" [Am J Med Sci. 369 (2025) 671-678].","authors":"Zixia Liu, Xieli Ma, Tian Chang, Chuanhui Yao, Mengge Song, Shang Biyue, Fuyuan Zhang, Jiameng Liu, Quan Jiang","doi":"10.1016/j.amjms.2025.07.014","DOIUrl":"https://doi.org/10.1016/j.amjms.2025.07.014","url":null,"abstract":"","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700794","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":"Association of Family History of Myocardial Infarction or Stroke with Vascular Parameters in Healthy Individuals: the EVasCu study and MUJER-EVA project.","authors":"Iván Cavero-Redondo, Carlos Pascual-Morena, José Alberto Martínez-Hortelano, Celia Álvarez-Bueno, Irene Martínez-García, Eva Rodríguez-Gutiérrez, Bruno Bizzozero-Peroni, Alicia Saz-Lara","doi":"10.1016/j.amjms.2025.07.004","DOIUrl":"https://doi.org/10.1016/j.amjms.2025.07.004","url":null,"abstract":"<p><strong>Background: </strong>The role of a family history of cardiovascular events in predisposing patients to cardiovascular diseases is recognized. Arterial stiffness, as measured by pulse wave velocity (PWv), is an emerging risk indicator. This study explores the association between a family history of cardiovascular events (i.e., myocardial infarction and stroke) and vascular and blood pressure parameters in healthy individuals.</p><p><strong>Methods: </strong>The cross-sectional EVasCu study in Cuenca, Spain, enrolled 390 healthy adults. Vascular (aortic PWv [aPWv], cardio-ankle vascular index [CAVI], ankle-brachial index [ABI], augmentation index [AIx@75]) and blood pressure (systolic blood pressure [SBP], diastolic blood pressure [DBP], pulse pressure [PP]) parameters, as well as other covariates, were measured. ANOVA and ANCOVA were used to assess the association between family history of myocardial infarction and stroke and vascular and blood pressure parameters.</p><p><strong>Results: </strong>The study group included 246 females and 144 males (Age: 42.05 ± 13.15 years). According to the unadjusted analyses, a family history of myocardial infarction was associated with increased SBP and PP (p = 0.015 and p = 0.012, respectively), with PP remaining significantly elevated in females (p = 0.003). These associations were largely attenuated after adjustment for sociodemographic, clinical, and lifestyle variables; however, PP remained significantly greater in females with a family history of myocardial infarction (p = 0.030), as supported by z score normalization (p = 0.036). Additionally, a family history of stroke was associated with significantly increased aortic pulse wave velocity (aPWv) in both the total sample and in females (p < 0.001 and p = 0.002, respectively), findings that remained significant after z score adjustment.</p><p><strong>Conclusion: </strong>Arterial stiffness emerges as a potential bridge between genetic predisposition and cardiovascular risk. Recognizing the importance of a family history of cardiovascular events in risk assessment and leveraging noninvasive measures of arterial stiffness could refine preventive strategies.</p>","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669152","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":"Presence of chronic complications differentiates in-hospital outcomes of transjugular intrahepatic portosystemic shunt in patients with diabetes mellitus.","authors":"Renxi Li, SeungEun Lee, William Rienas, Shawn Sarin","doi":"10.1016/j.amjms.2025.07.011","DOIUrl":"10.1016/j.amjms.2025.07.011","url":null,"abstract":"<p><strong>Background: </strong>Transjugular intrahepatic portosystemic shunt (TIPS) is an interventional radiological procedure to reduce portal hypertension. Hyperglycemic state in diabetes mellitus (DM) is associated with vascular injuries that can lead to chronic complications, which is implicative of the extent/control of DM. This study aimed to use chronic complications as a marker for uncontrolled DM and examine major in-hospital outcomes after TIPS among DM patients with (DM-WCC) and without chronic complications (DM-WOCC).</p><p><strong>Materials: </strong>Patients who underwent TIPS were identified in the National Inpatient Sample (NIS) from Q4 2015-2020. DM-WCC and DM-WOCC were identified using the Elixhauser comorbidity measure. In-hospital post-TIPS outcomes between DM-WCC, DM-WOCC, and non-DM patients were compared using multivariable logistic regression.</p><p><strong>Results: </strong>NIS identified 1199 DM-WOCC, 1229 DM-WCC, and 4230 non-DM. Compared to non-DM, DM-WOCC had lower in-hospital mortality (aOR=0.661, 95 CI=0.493-0.885, p = 0.01) and renal complications (aOR=0.632, 95 CI=0.534-0.749, p < 0.01). Compared to non-DM, DM-WCC had higher renal complications (aOR=1.366, 95 CI=1.174-1.591, p < 0.01) and hepatic encephalopathy (HE; aOR=1.378, 95 CI=1.189-1.597, p < 0.01). Compared to DM-WOCC, DM-WCC had higher mortality (aOR=1.452, 95 CI=1.025-2.057, p = 0.04), renal complications (aOR=2.165, 95 CI=1.774-2.641, p < 0.01), and HE (aOR=1.247, 95 CI=1.045-1.487, p = 0.01). DM-WOCC had shorter length of stay and less total hospital costs than both DM-WCC and non-DM.</p><p><strong>Conclusions: </strong>The presence of chronic complications in DM may differentiate the risk of complications after TIPS, where DM-WCC patients had worse outcomes, while DM-WOCC seems to be protective. Managing diabetic chronic complications may be helpful to avoid adverse outcomes after TIPS.</p>","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669154","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":"Exploring the Obesity Paradox: A Multisystem Review.","authors":"Kanishk Aggrawal, Vasu Gupta, Baltej Singh, Raunak Medatwal, Shivank Singh, Pranjal Jain, Rohit Jain","doi":"10.1016/j.amjms.2025.07.010","DOIUrl":"https://doi.org/10.1016/j.amjms.2025.07.010","url":null,"abstract":"<p><p>Obesity has plagued the entire world and is a known risk factor across the spectrum of diseases involving neurological, cardiovascular, pulmonary, gastrointestinal, and hematological and is commonly associated with poor clinical outcomes. Obesity paradox is a concept that contradicts the prevailing medical knowledge by proposing the notion that obese patients have better mortality, morbidity, and survival rates when compared to the non-obese patient population suffering with the similar medical conditions. Although observed more commonly in patients with cardiovascular diseases, more research is coming forward citing the similar effects in critically ill patients, those with chronic kidney disease, end stage renal disease, and cancer patients. Despite extensive research, the underlying mechanisms of the Obesity Paradox remain unclear, complicated by the reliance on BMI and the neglect of confounding factors like age, comorbidities, socioeconomic status, and one of the commonly proposed solutions is to make use of other anthropological indices of obesity. This calls for a more in-depth dive into this issue to find an explanation behind this paradox or even more to confirm if it actually exists.</p>","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669153","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":"Double-Filtration Plasmapheresis versus Therapeutic Plasma Exchange in the Treatment of Anti-Glomerular Basement Membrane Nephritis: A Cohort Study.","authors":"Caihong Liu, Wei Wei, Yongxiu Huang, Xu Li, Xiaorong Huang, Letian Yang, Zhiwen Chen, Yingying Yang, Ping Fu, Ling Zhang, Yuliang Zhao","doi":"10.1016/j.amjms.2025.07.007","DOIUrl":"https://doi.org/10.1016/j.amjms.2025.07.007","url":null,"abstract":"<p><strong>Background: </strong>Therapeutic plasma exchange (TPE) is acknowledged as the standard therapy for anti-glomerular basement membrane (GBM) nephritis. In recent years, double-filtration plasmapheresis (DFPP) has been proposed as an equally effective plasmapheresis modality. The present study aimed to compare the efficacy and safety of TPE and DFPP for the treatment of anti-GBM nephritis.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of anti-GBM patients who received plasmapheresis from February 2011 to October 2023 at West China Hospital of Sichuan University. The primary outcome was a composite endpoint of in-hospital death or dialysis dependency at discharge. The secondary outcomes included length of hospitalization, long-term mortality and end-stage renal disease (ESRD). We also compared anti-GBM antibody titer reduction, plasmapheresis-related adverse events. Logistic regression and Cox hazard proportional regression analyses were performed to investigate potential risk factors of primary outcome and long-term patient/renal survival.</p><p><strong>Results: </strong>In total, 58 anti-GBM nephritis patients were included in this study. No significant differences were observed in the incidence of primary outcome between patients receiving DFPP and TPE in fully adjusted logistic regression model (OR=0.23, 95% CI=0.04-1.37, P=0.106). In surviving patients, the length of hospitalization was similar (21 vs. 23 days, P=0.165). With a follow-up of 3-years, K‒M survival analysis revealed similar risk of death or ESRD between the 2 groups (P=0.424; P=0.987). According to fully adjusted Cox regression analyses, anti-GBM nephritis patients receiving DFPP achieved comparable patient (HR=1.18, 95% CI=0.23-6.04; P=0.845) and kidney survival (HR=0.96, 95% CI=0.13-6.86; P=0.967) to those receiving TPE. After plasmapheresis treatment, the anti-GBM antibody concentration significantly decreased in both groups (DFPP: 136.47 vs 27.20 AU/mL, P<.001; TPE: 122.09 vs 27.40 AU/mL, P=0.016), with fewer allergy episodes observed in the DFPP group (13.64% vs 42.86%, P=0.049). Besides, older age and concomitant infection were independently related to 3-year patient mortality (P<0.001, P=0.031), whereas high-dose methylprednisolone treatment seemed to be associated with a lower risk of ESRD (P=0.034).</p><p><strong>Conclusions: </strong>Anti-GBM nephritis patients who received DFPP achieved comparable short- and long-term prognosis to those who received TPE. With less plasma consumption, DFPP was also associated with fewer allergy episodes. DFPP might be an alternative modality of plasmapheresis for anti-GBM nephritis, especially in the setting of limited blood resources.</p>","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661487","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":"A rare presternal goiter: presentation and literature review.","authors":"V Naraynsingh, M Maharaj, S Hassranah, S Maharajh, R Maharaj","doi":"10.1016/j.amjms.2025.07.005","DOIUrl":"https://doi.org/10.1016/j.amjms.2025.07.005","url":null,"abstract":"<p><p>Presternal goiters are incredibly rare presentations worldwide; very little is known about their genesis despite many hypotheses and even fewer cases are seen in our medical literature. The commonest pathology for presternal goiters is papillary carcinoma of the thyroid (PCT), typically presenting as a solitary cystic cervical mass. Differential diagnoses are vast causing diagnostic difficulty, prompting crucial pre-operative radiological investigations and pathological confirmation. Curative management in all cases of malignant presternal goiters is total thyroidectomy with a modified radical neck dissection where indicated. Post operative radioiodine ablation and suppressive thyroxine therapy are often used and serial thyroglobulin surveillance is done. Interestingly, this is the first documented case in which previous cardiac surgery with mediastinal scarring and deficiency in the deep cervical fascia maybe predisposing factors. Therefore, we propose two new theories in the causation of this rare phenomenon.</p>","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661486","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":"Utility of glucagon-like-peptide-1-receptor agonists in mast cell activation syndrome.","authors":"Lawrence B Afrin, Leonard B Weinstock, Tania T Dempsey, Katja Aschenbrenner, Svetlana Blitshteyn, Jill R Schofield","doi":"10.1016/j.amjms.2025.07.006","DOIUrl":"10.1016/j.amjms.2025.07.006","url":null,"abstract":"<p><strong>Introduction: </strong>Mast cell (MC) activation syndrome (MCAS) is a collection of illnesses rooted in inappropriate MC activation with little to no neoplastic MC proliferation, distinguishing it from mastocytosis. Due to great heterogeneity in the underlying MC regulatory gene mutational profiles present in most cases and resulting great heterogeneity in aberrant expression of the hundreds of potent mediators known to be expressed by MCs, MCAS presents with great heterogeneity but dominantly manifests as chronic multisystem polymorbidity of generally inflammatory, allergic, and dystrophic phenotypes. MCAS's heterogeneity at multiple levels poses challenges for identifying optimal individual treatment. Targeting commonly affected downstream effectors of the disease's various symptoms may yield clinical benefit independent of the root/upstream mutational profile in the individual patient. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) engage with GLP-1 receptors present on many types of cells, including MCs. These drugs are already approved for management of a few chronic inflammatory diseases (e.g., diabetes mellitus type 2, obesity, obstructive sleep apnea) but are increasingly being appreciated to help in a wide range of other inflammatory diseases.</p><p><strong>Methods: </strong>We present the first case series showing utility of a variety of GLP-1RAs for managing refractory MCAS in a diverse assortment of such patients.</p><p><strong>Results: </strong>Among 47 cases (mean age 39, range 15-71, 89 % female), 89 % demonstrated clinical benefit with GLP-1RAs for a broad range of problems associated with MCAS.</p><p><strong>Conclusion: </strong>GLP-1RAs may have substantial benefit in MCAS. Randomized controlled trials are needed to assess the efficacy, and identify optimal dosing, of GLP-1RA treatment in MCAS.</p>","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661490","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":"Grit and Resilience Among Pulmonary and Critical Care Physicians: A Multi-Institutional Study.","authors":"Alan W Hu, Thomas J Beckman, Allison M LeMahieu, Helen M Keetley, Rosemary Adamson, Hitesh H Patel, Dustin C Krutsinger, Joshua L Denson, Sarah Dhannoon, David C Chu, Diana J Kelm","doi":"10.1016/j.amjms.2025.07.009","DOIUrl":"https://doi.org/10.1016/j.amjms.2025.07.009","url":null,"abstract":"<p><p>Pulmonary and Critical Care Medicine (PCCM) physicians work in stressful environments and are at risk for burnout. Grit and resilience have been shown to protect against burnout in various medical specialties, but this relationship has not been explored among PCCM physicians. The purpose of this study was to determine associations between grit and resilience with burnout, academic productivity, and COVID-19-related clinical experiences in PCCM fellows and faculty. A cross-sectional, multi-institutional survey was conducted during the 2022-2023 academic year among PCCM fellows and faculty from six academic institutions. Measures included the Short Grit Scale, Connor-Davidson Resilience scale, single-item measures of emotional exhaustion and depersonalization, ICU-level COVID-19 experience, and academic productivity metrics. Mixed-effects proportional odds regression models assessed relationships between grit, resilience, burnout, and academic performance, considering clustering within institutions. One hundred and thirty-one participants were surveyed with a response rate of 40.3%. Median scores for grit, burnout, and resiliency were 3.8 (0-5), 4 (0-12), and 31 (0-40), respectively. Higher grit correlated with less burnout (OR=0.34, p<0.001), fewer PubMed publications (OR=0.57, p=0.048), and more national or international presentations (OR=1.99, p=0.027). Higher resilience was associated with less burnout (OR=0.90, p=0.001). This is the first study to examine grit and resilience in the field of PCCM. Higher grit and resilience were associated with less burnout in PCCM physicians. Additionally, physicians with higher grit and resilience scores experienced more COVID-19 related deaths. Given the intense and emotionally taxing nature of PCCM, further research on interventions to optimize grit and resilience in PCCM physicians is needed.</p>","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661488","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}