The American journal of the medical sciences最新文献

{"title":"Assessment of the association between constipation and atherosclerosis in cardiovascular and cerebrovascular diseases: a systematic review and meta-analysis.","authors":"Xiang Wang, Kaiwen Zheng, Quan Zhang","doi":"10.1016/j.amjms.2025.04.001","DOIUrl":"https://doi.org/10.1016/j.amjms.2025.04.001","url":null,"abstract":"<p><p>This study examines the association between constipation and cardiovascular and cerebrovascular diseases linked to atherosclerosis. A systematic review of studies published from 2000 to August 2024 was performed using PubMed, Web of Science, Cochrane, and EMBASE databases. Twelve studies, encompassing 5,772,682 adults from six countries, met inclusion criteria and were quality-assessed via the NOS and AHRQ scales. Meta-analysis results indicated a significant association, with an odds ratio of 1.18 (95% CI: 1.08-1.30), suggesting that constipation may elevate the risk of atherosclerosis-related cardiovascular and cerebrovascular conditions.</p>","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789267","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":"Evaluation of the efficacy of Omalizumab as re-treatment in patients with severe asthma.","authors":"Müge Gençer Tuluy, Yavuz Havlucu, Deniz Kızılırmak, Ayşe Arzu Yorgancıoğlu","doi":"10.1016/j.amjms.2025.03.012","DOIUrl":"https://doi.org/10.1016/j.amjms.2025.03.012","url":null,"abstract":"<p><strong>Objective: </strong>Omalizumab is an anti-IgE monoclonal antibody used to treat severe allergic asthma. In this study, we aimed to investigate the efficacy of omalizumab re-treatment in patients who discontinued omalizumab treatment for any reason.</p><p><strong>Methods: </strong>Patients who received omalizumab treatment for at least two years, whose treatment was shown to be successful, and who received omalizumab for at least one year in retreatment were included in the study. Asthma treatment, pulmonary function tests, asthma control test scores, and the number of asthma attacks, asthma attacks requiring systemic corticosteroid use, asthma attacks requiring systemic corticosteroid use, systemic corticosteroid treatment, unplanned physician visits, emergency department visits, and hospitalizations in a year were recorded both before and after first treatment and before and after re-treatment.</p><p><strong>Results: </strong>A total of 36 patients with severe persistent asthma were included. The mean time to restart treatment was 16.5±10.1 months. After re-treatment, the asthma control test score and the number of asthma attacks, asthma attacks requiring systemic corticosteroid use, systemic corticosteroid treatment, unplanned doctor visits, emergency department visits and hospitalizations in one year were statistically significantly reduced. In terms of side effects, no serious side effects were observed in any patient and side effects were like those of the first treatment.</p><p><strong>Conclusions: </strong>In our study, omalizumab was found to be as effective and safe as the first treatment in patients who had previously received and discontinued omalizumab treatment and in whom treatment was restarted due to deterioration in asthma control.</p>","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143766196","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":"MiR-486-5p predicts the progression of severe acute pancreatitis by mediating the inflammatory response and ATG7/p38 MAPK pathway.","authors":"Yang Wang, Qi Ni, Shuying Xu, Mingli Cui, Ruixia Wang, Rong Liu","doi":"10.1016/j.amjms.2025.01.011","DOIUrl":"10.1016/j.amjms.2025.01.011","url":null,"abstract":"<p><strong>Background: </strong>Acute pancreatitis (AP) is a serious disorder, and is frequently accompanied by shock or organ failure. The study aimed to investigate the predictive value of serum miR-486-5p for the prognosis of SAP patients and the underlying mechanism.</p><p><strong>Methods: </strong>The concentration of mRNAs was detected by Real-Time PCR reaction. The correlation between miRNA and each scoring system was analyzed via Pearson's correlation analysis. ROC curve was performed for diagnostic value evaluation. The predictive value of miRNA expression in the severity of AP was estimated by logistic regression analysis. HPDE6-C7 cells were treated with cerulein (Cer) to mimic AP in vitro. The cell apoptosis, viability, and inflammatory response were detected by flow cytometry, CCK-8, and ELISA, respectively. The targeting relationship was verified by DLR assay and RIP assay.</p><p><strong>Results: </strong>The expression of miR-486-5p was elevated in the serum of non-SAP and SAP groups (P < 0.001), which was interconnected with APACHE II, SOFA, and Ranson scores. MiR-486-5p can differentiate SAP patients from non-SAP with the AUC of 0.916, and it was an independent risk for the severity of AP patients. The miR-486-5p/ATG7 axis affected the apoptosis, viability, and inflammatory response of HPDE6-C7 cell models by the p38 MAPK pathway, thus involving the progression of AP.</p><p><strong>Conclusions: </strong>Serum miR-486-5p may have a certain predictive value for the severity of AP and influence AP development through mediating cell inflammatory response via targeting ATG7.</p>","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143766197","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":"Inflammation Factors Mediate the Association between Heavy Metal and Homa-IR Index: an Integrated Approach from the NHANES (2011∼2016).","authors":"Qingsong Mao, Xinyi Zhang, Xiaoyi Zhu, Xinling Tian, Yuzhe Kong","doi":"10.1016/j.amjms.2025.03.013","DOIUrl":"https://doi.org/10.1016/j.amjms.2025.03.013","url":null,"abstract":"<p><strong>Background: </strong>The interplay between heavy metals exposure and insulin resistance (IR), specifically through the mediation of inflammation factors, is crucial for understanding metabolic disturbances. This study utilizes data from the NHANES (2011∼2016) to investigate these relationships in a large, diverse U.S.</p><p><strong>Population: </strong></p><p><strong>Method: </strong>The study analyzed the associations between heavy metals (cadmium (Cd), lead (Pb), mercury (Hg), manganese (Mn)) and the Homeostatic Model Assessment for Insulin Resistance (Homa-IR) index. The analyses included descriptive statistics, Pearson's correlations, linear and non-linear regression models, and advanced statistical models such as Weighted Quantile Sum (WQS) regression and Bayesian Kernel Machine Regression (BKMR). Inflammation factors were assessed for their mediating role in these associations.</p><p><strong>Result: </strong>The findings highlighted significant positive correlations between specific heavy metals and the Homa-IR index. Both linear and non-linear associations were evident, with certain metals showing a more pronounced impact in the presence of high inflammation markers. It was found that the Homa-IR index was negatively associated with Pb (β (95%CI) = -0.0126 (-0.0238 ∼ -0.0015), P=0.0268) and Hg (β (95%CI) = -0.0090 (-0.0180 ∼ -0.0001), P=0.0487). The WQS regression indicated an overall positive relationship between heavy metal mixtures (Estimate: 0.0050, P<0.05) and the Homa-IR index where Cu had the highest weights (0.7741), while BKMR analyses detailed the varying effects of individual metals at different exposure levels. In the mediation analysis, it can be found that monocyte (Mono) mediated the association between Pb and Homa-IR index (direct effect: -0.0546, indirect effect: -0.0082) and neutrophil (Neu) (direct effect: -0.0521, indirect effect: -0.0047) can mediate the association between Hg and Homa-IR index.</p><p><strong>Conclusion: </strong>This study confirms that exposure to heavy metals is associated with increased insulin resistance and that inflammation significantly mediates this relationship. Understanding these pathways is essential for developing targeted interventions to mitigate the metabolic consequences of environmental exposures.</p>","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756657","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":"Mortality patterns of coronary artery diseases and atrial fibrillation in adults in the United States from 1999 to 2022: An analysis using CDC WONDER.","authors":"Muzamil Akhtar, Muhammad Hamza Dawood, Muheem Khan, Muhammad Raza, Mehmood Akhtar, Sultana Jahan, Matthew Bates, Aneesh Challa, Raheel Ahmed, Abdul Khaliq Naveed, Yasar Sattar","doi":"10.1016/j.amjms.2025.03.011","DOIUrl":"10.1016/j.amjms.2025.03.011","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery disease (CAD) and atrial fibrillation (AF) contribute significantly to global mortality and frequently co-exist due to shared risk factors like hypertension and diabetes. This study seeks to explore the relatively overlooked area of mortality patterns among adults who have both coronary artery disease and atrial fibrillation.</p><p><strong>Methods: </strong>Mortality data for individuals aged ≥25 were obtained from CDC WONDER using ICD-10 codes I20-25 (CAD) and I48 (AF). Age-adjusted mortality rates (AAMR) and crude mortality rates per 100,000 were calculated. Trends were analyzed by gender, year, race, urbanization, and state. JoinPoint regression estimated annual percent change (APC) and average annual percent change (AAPC) with 95 % confidence intervals (CI).</p><p><strong>Results: </strong>From 1999 to 2022, there were 942,461 recorded deaths among individuals with CAD and AF in the United States. The AAMR rose from 14.35 in 1999 to 24.53 in 2022, resulting in an AAPC of 2.56* (95 % CI, 2.24 - 2.85). The AAMR showed a consistent increase throughout the study period, with a significant spike from 2018 to 2022 (APC: 6.87*; 95 % CI, 4.82 - 10.66). Men consistently had higher AAMRs than women. Non-Hispanic (NH) White individuals reported the highest AAMR, followed by NH Black, Hispanic, and NH other populations. Nonmetropolitan areas exhibited higher AAMR than metropolitan regions.</p><p><strong>Conclusions: </strong>AAMR showed a moderate rise from 1999-2018, followed by a sharp increase from 2018-2022, possibly linked to COVID-19. Further research is needed to understand contributing factors.</p>","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143695056","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":"Bicaval thrombosis and systemic-to-pulmonary venous shunting: A case report and systematic review of the literature.","authors":"Ali Haider Jafry, Muhammad Ibraiz Bilal, Muhammad Hurera, Usama Munawar, Muhammad Hazqeel Kazmi, Syeda Maheen Raza, Georgios Lygouris","doi":"10.1016/j.amjms.2025.03.006","DOIUrl":"10.1016/j.amjms.2025.03.006","url":null,"abstract":"<p><p>Systemic-to-pulmonary venous shunts (SPVSs) in the setting of combined superior and inferior venae cavae occlusion are exceedingly rare. A 52-year-old female with antiphospholipid syndrome and venous thromboembolism (on Coumadin) was admitted with shortness of breath and profound hypoxia. She had a retained fractured dialysis catheter from the superior to inferior vena cava. Imaging showed thrombotic bicaval occlusion, with extensive collateralization from peri‑hepatic and chest wall veins to the right pulmonary veins. Due to poor neurological status due to hypoxic brain injury and refractory hypoxemia, family opted to pursue comfort care. A comprehensive literature search yielded 29 additional cases of SPVSs, with a male majority (53 %) and mean age of 43.5 years. Only 7 cases (∼23 %) reported bicaval obstruction, all occurring during or after the year 2000. We highlight SPVSs as a possible cause of refractory hypoxia. Early intervention to relieve central obstruction and exclude SPVSs is the cornerstone of management.</p>","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665615","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 risk of skin infections in end-stage renal disease patients with porphyria cutanea tarda: A retrospective cohort study.","authors":"Edwine K Coulanges, Resean M Wallace, Jennifer L Waller, Stephanie L Baer, Wendy B Bollag","doi":"10.1016/j.amjms.2025.03.010","DOIUrl":"10.1016/j.amjms.2025.03.010","url":null,"abstract":"<p><strong>Background: </strong>Porphyria cutanea tarda (PCT) is one of many conditions characterized by increased photosensitivity, manifesting as blistering lesions on sun-exposed skin. Due to the increased photosensitivity and skin fragility, PCT patients are more susceptible to infections. Individuals with end-stage renal disease (ESRD), a potential complication of PCT, also exhibit an increased risk of infection. Due to these combined risks, this retrospective cohort study sought to determine if PCT is an independent risk factor for certain infections in the ESRD population.</p><p><strong>Methods: </strong>This study examined dialysis recipients within the United States Renal Data System database from 2005 to 2019. A diagnosis of PCT was determined using International Classification of Disease (ICD)-9 and ICD-10 codes and identified 1,019 (0.07 %) out of a total of 1,398,765 ESRD patients who met the inclusion and exclusion criteria. Bacterial infections, cellulitis, blisters, abscesses, and bacteremia were queried as outcomes. Logistic regression analysis determined the impact of PCT on the risk of each infection after controlling for demographic and clinical factors.</p><p><strong>Results: </strong>PCT was associated with a significantly decreased risk for 3 out of the 5 outcomes: bacterial infections (adjusted odds ratio: 0.50; 95 % confidence interval: 0.43-0.58), cellulitis (0.61; 0.53-0.71), and bacteremia (0.44; 0.38-0.52). No significant positive or negative association was found between PCT and blisters or abscesses.</p><p><strong>Conclusions: </strong>These results indicate that ESRD patients with PCT are actually at decreased risk of some infections compared with ESRD patients without comorbid disease. The reason is unclear but could be related to either the disease process or its clinical management.</p>","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652474","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 TyG index correlation with invasive ventilator in critically ill patients: A retrospective analysis of the MIMIC-IV database.","authors":"Jie Hu, Jie Min, Dan Zong","doi":"10.1016/j.amjms.2025.03.009","DOIUrl":"10.1016/j.amjms.2025.03.009","url":null,"abstract":"<p><strong>Background: </strong>Insulin resistance is common in critically ill patients. It is not known whether it is associated with the use of invasive ventilation. This study investigated the relationship between the triglyceride glycemic index (TyG) and the risk of invasive ventilator use in critically ill patients admitted to the intensive care unit (ICU).</p><p><strong>Methods: </strong>The study utilized the Medical Information Mart for Intensive Care-IV database. All patients were divided into three groups according to the TyG index. The study employed univariable and multivariable logistic regression analysis, competing risk analysis, and 4-knot multivariate restricted cubic spline regression. ROC curves were used to determine if the TyG index improves the predictive value of disease scores.</p><p><strong>Results: </strong>Out of 2196 participants, 51.9 % had invasive ventilation. Multivariable logistic regression analyses and competing risk analyses revealed that the risk of Invasive ventilator use was significantly higher in the highest quartile of the TyG index. Meanwhile, the RCS analysis indicated S-typed relationships between the TyG index and invasive ventilator use, with inflection points at 9.40, respectively. The TyG index had an incremental effect on the AUC of existing severity of illness scores to predict invasive ventilation.</p><p><strong>Conclusion: </strong>This study shows that an increased TyG index is a significant risk factor for invasive ventilation in patients in the ICU.</p>","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143635042","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":"Octreotide therapy in patients with a left ventricular assist device and bleeding gastrointestinal angiodysplasias.","authors":"Ahmed Ibrahim, Jad Allam, Don C Rockey","doi":"10.1016/j.amjms.2025.03.008","DOIUrl":"10.1016/j.amjms.2025.03.008","url":null,"abstract":"<p><strong>Background: </strong>Angiodysplasias commonly develop in patients with left ventricular assist devices (LVADs) and often bleed recurrently. Whether octreotide reduces the burden of angiodysplasia or the frequency of bleeding in these patients is controversial. Hence, we aimed to study the effect of long-acting octreotide on angiodysplasia bleeding in LVAD patients.</p><p><strong>Methods: </strong>Between May 2012 and December 2023, 65 patients with LVAD and angiodysplasia were identified at our tertiary care medical center. Of those, 33 patients received octreotide therapy. Complete clinical data were abstracted from the medical record, and outcomes pre and post octreotide therapy were examined.</p><p><strong>Results: </strong>In 33 patients (61 ± 8 years old and 9 women) who received long-acting octreotide for recurrent angiodysplasia bleeding that failed to respond to endoscopic therapy, the small intestine was the most common site involved. Prior to octreotide, patients received an average of 2.0 ± 3.0 units/month of PRBCs over an average of 16 months, which decreased to 0.5 ± 0.8 units/month over 31 months on therapy. Over an average period of 31 months on octreotide therapy, GI bleeding events and the number of endoscopic therapies per month decreased from 0.4 ± 0.2 to 0.1 ± 0.2 (p = 0.01) and from 0.7 ± 0.8 to 0.1 ± 0.2 (p = 0.001), respectively. Finally, hemoglobin and hematocrit levels increased over the 31 month follow-up period while on octreotide therapy.</p><p><strong>Conclusion: </strong>In patients with an LVAD and recurrent angiodysplasia bleeding, octreotide appeared to reduce the number of GI bleeding events, the need for GI endoscopic therapies, and the frequency of PRBC transfusions.</p>","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631152","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":"Geographic disparities and emerging hotspot trends of long COVID in the United States.","authors":"Anand Gourishankar","doi":"10.1016/j.amjms.2025.03.005","DOIUrl":"10.1016/j.amjms.2025.03.005","url":null,"abstract":"<p><strong>Objectives: </strong>To study the emerging hotspot pattern of Long COVID (LC) in the U.S. population and investigate the correlation between Long COVID and state health system performance.</p><p><strong>Methods: </strong>Using 2022 to 2024 Center for Disease Control and Prevention adult LC data, I applied the Getis-Ord Gi* statistic with the Mann-Kendall trend test to determine emerging temporal trends associated with local clustering patterns across the contiguous states. A Pearson's correlation tested LC rates and state health system performance.</p><p><strong>Results: </strong>A spatiotemporal trend map described discrete patterns. In 2023, Long COVID rates were highest in Southeastern states such as Mississippi and West Virginia, but by 2024, mixed patterns were observed in some states. The LC rates showed an inverse relationship with state health outcome scores (r = -0.69, P < 0.001). Emerging hotspot analysis identified Mississippi as a persistent hotspot for Long COVID. Northeastern states showed consistently persistent cold spots.</p><p><strong>Conclusions: </strong>The states with better health outcomes showed a lower frequency of long COVID. The geographically emerging hot spots can guide focused intervention and resource allocation for these patients.</p>","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631151","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}