The American journal of the medical sciences最新文献_第3页

Unravelling the "diabetes discrepancy": The presence of chronic complications is a hallmark of worse short-term outcomes in patients with diabetes mellitus after transcatheter aortic valve replacement. 揭示“糖尿病差异”：慢性并发症的出现是经导管主动脉瓣置换术后糖尿病患者短期预后较差的标志。

IF 1.8

The American journal of the medical sciences Pub Date : 2025-09-04 DOI: 10.1016/j.amjms.2025.09.004

Renxi Li, Brian G Choi

{"title":"Unravelling the \"diabetes discrepancy\": The presence of chronic complications is a hallmark of worse short-term outcomes in patients with diabetes mellitus after transcatheter aortic valve replacement.","authors":"Renxi Li, Brian G Choi","doi":"10.1016/j.amjms.2025.09.004","DOIUrl":"10.1016/j.amjms.2025.09.004","url":null,"abstract":"Background: In transcatheter aortic valve replacement (TAVR), there is a notable \"diabetes discrepancy\", where worse/better/similar outcomes were all found for patients with diabetes mellitus (DM). Such divergent findings pose a challenge for clinicians to accurately assess the risks for DM patients undergoing TAVR. We hypothesized the presence of chronic complications could be linked to worse post-TAVR outcomes in DM patients. Therefore, this study aimed to compare the short-term outcomes of TAVR between DM patients with chronic complications (DM-CC), those without complications (DM-NCC), and non-diabetic individuals (non-DM).Methods: Patients who underwent TAVR were identified in National Inpatient Sample database from Q4 2015 to 2020. In-hospital post-TAVR outcomes were compared between DM-CC, DM-NCC, and non-DM. Multivariable logistic regression was used to adjust for demographics, socioeconomic status, primary payer status, hospital characteristics, transfer status, admission status, comorbidities and relevant diagnoses, and access site.Results: There were 22,168 DM patients (9388 DM-CC and 12,780 DM-NCC) and 36,682 non-DM patients underwent TAVR. DM-CC were found to have worse outcomes than non-DM, which included adjusted risks of cardiac, neurological, pulmonary, and renal system complications, wound complications, hemorrhage, longer length of stay (LOS), and higher hospital charges. However, compared to non-DM, DM-NCC had lower in-hospital mortality, cardiac and renal system complications, infection, and superficial wound complications, as well as shorter LOS.Conclusions: The presence of diabetic chronic complications could be a hallmark for worse short-term outcomes after TVAR, which may unravel the long-debated \"diabetes discrepancy\" in TAVR and provide insights into preoperative risk stratification for DM patients.","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008668","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}

引用次数: 0

Advances in research on monogenic hereditary hypertension. 单基因遗传性高血压的研究进展。

IF 1.8

The American journal of the medical sciences Pub Date : 2025-09-04 DOI: 10.1016/j.amjms.2025.09.002

Bingjie Guo, Mengyuan Li, Yingqing Feng, Junying Yang, Hongwei Jiang

引用次数: 0

CircCOL3A1 ameliorates myocardial ischemia-reperfusion injury by regulating miR-29b-3p/MDM2-mediated apoptosis. CircCOL3A1通过调节miR-29b-3p/ mdm2介导的细胞凋亡改善心肌缺血再灌注损伤。

IF 1.8

The American journal of the medical sciences Pub Date : 2025-08-28 DOI: 10.1016/j.amjms.2025.08.021

Lihua Sun, Siyan Shi, Weihao Wang, Ying Zhang

{"title":"CircCOL3A1 ameliorates myocardial ischemia-reperfusion injury by regulating miR-29b-3p/MDM2-mediated apoptosis.","authors":"Lihua Sun, Siyan Shi, Weihao Wang, Ying Zhang","doi":"10.1016/j.amjms.2025.08.021","DOIUrl":"https://doi.org/10.1016/j.amjms.2025.08.021","url":null,"abstract":"Background: Cardiovascular diseases (CVDs) are leading causes of mortality globally, with myocardial ischemia-reperfusion (I/R) injury being a critical challenge in clinical settings. Circular RNAs (circRNAs) have emerged as significant molecular players in various pathophysiological conditions, including myocardial I/R injury.Objective: This study aimed to investigate the role of circCOL3A1 in myocardial I/R injury and its potential regulatory mechanisms involving miR-29b-3p and MDM2.Methods: Using a mouse model and H9c2 cardiomyocyte cells, we examined the expression levels of circCOL3A1 under I/R and hypoxia/reoxygenation (H/R) conditions. We utilized RT-qPCR, Western blotting, terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL), and dual-luciferase reporter assays to explore the interaction between circCOL3A1, miR-29b-3p, and MDM2.Results: CircCOL3A1 was significantly downregulated in both I/R-treated mice and H/R-treated H9c2 cells. Overexpression of circCOL3A1 reduced apoptosis and improved cell viability by modulating the miR-29b-3p/MDM2 axis. These effects were reversed by overexpressing miR-29b-3p or silencing MDM2.Conclusion: CircCOL3A1 plays a protective role in myocardial I/R injury by acting as a miR-29b-3p sponge, thereby regulating the MDM2-mediated apoptosis pathway. This identifies circCOL3A1 as a potential therapeutic target for treating myocardial I/R injury.","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984512","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}

引用次数: 0

Development of a novel combined model integrating electrolyte indicators to evaluate ascites recompensation in HBV-related decompensated cirrhosis. 结合电解质指标评价hbv相关失代偿肝硬化腹水再代偿的新型组合模型的建立。

IF 1.8

The American journal of the medical sciences Pub Date : 2025-08-27 DOI: 10.1016/j.amjms.2025.08.016

Jie Chen, Huaqian Xu, Liang Zhang, Shanhong Tang

{"title":"Development of a novel combined model integrating electrolyte indicators to evaluate ascites recompensation in HBV-related decompensated cirrhosis.","authors":"Jie Chen, Huaqian Xu, Liang Zhang, Shanhong Tang","doi":"10.1016/j.amjms.2025.08.016","DOIUrl":"10.1016/j.amjms.2025.08.016","url":null,"abstract":"Objective: Ascites is one of the common complications of hepatitis B virus (HBV) -related cirrhosis, which predicts a poor clinical prognosis for cirrhosis patients. Electrolyte disturbance is often observed in such patients. In our study, we developed a novel combined model integrating electrolyte indicators to evaluate the prognostic value of electrolyte indicators in ascites recompensation in HBV-related decompensated cirrhosis.Methods: A retrospective cohort of 350 patients with HBV-related decompensated cirrhosis and ascites was categorized into recompensated (n = 117) and non-recompensated (n = 233) groups based on 2-year outcomes. Participants were randomly divided into training (n = 263) and validation (n = 87) cohorts. Multivariable logistic regression identified independent predictors, followed by nomogram construction. Model performance was assessed using receiver operating characteristic-area under the curve, calibration curves, and decision curve analysis.Results: Serum chloride (OR = 1.08, P < 0.01), serum calcium (OR = 8.3, P < 0.01), and hepatic encephalopathy (HE) (OR = 0.06, P < 0.01) were independent predictors of recompensation. The nomogram demonstrated moderate predictive accuracy in the validation cohort (AUC = 0.762; 95 % CI: 0.653-0.871), with balanced sensitivity (59.3 %) and specificity (70.0 %). Calibration curves confirmed good agreement between predicted and observed outcomes (P > 0.05). DCA indicated superior clinical utility across risk thresholds (10-80 %).Conclusions: A nomogram integrating serum chloride, calcium, and HE effectively predicts recompensation in HBV-related decompensated cirrhosis with ascites, offering actionable guidance for clinical management.","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984450","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}

引用次数: 0

Cardiovascular disease and inpatient complications in Raynaud's syndrome: Propensity score analysis. 雷诺综合征的心血管疾病和住院并发症：倾向评分分析。

IF 1.8

The American journal of the medical sciences Pub Date : 2025-08-26 DOI: 10.1016/j.amjms.2025.08.020

Talal Alzahrani

{"title":"Cardiovascular disease and inpatient complications in Raynaud's syndrome: Propensity score analysis.","authors":"Talal Alzahrani","doi":"10.1016/j.amjms.2025.08.020","DOIUrl":"10.1016/j.amjms.2025.08.020","url":null,"abstract":"Background: Raynaud's Syndrome (RS) is a vasospastic disorder characterized by intermittent episodes of arterial vasospasm of the extremities. The relationship between RS and cardiovascular outcomes is not well studied, particularly among hospitalized patients. This study aims to examine the relationship between RS and clinical outcomes among hospitalized patients.Methods: The National Inpatient Sample (NIS) database was used to identify patients with RS using the ICD-10 code (RS: I73.0). Propensity score matching was performed to balance baseline demographic and clinical characteristics between patients with and without RS. CVD, rheumatological diseases, and inpatient outcomes were compared between the two groups before and after matching.Results: RS patients had significantly higher rates of ischemic heart disease (22.9 % vs. 19.5 %; p < 0.01), heart failure (19.2 % vs. 14.5 %; p < 0.01), and pulmonary arterial hypertension (12.4 % vs. 4.0 %; p < 0.01). Rheumatological co-morbidities, including systemic sclerosis (14.6 % vs. 0.2 %; p < 0.01) and systemic lupus erythematosus (14.2 % vs. 0.8 %; p < 0.01), were more prevalent in RS patients. Inpatient complications, particularly acute decompensated heart failure (5.9 % vs. 4.5 %; p < 0.01), were more common in RS patients.Conclusions: Patients with RS had a higher prevalence of cardiovascular and rheumatological diseases and were associated with inpatient complications. These findings emphasize the importance of comprehensive cardiovascular and rheumatological disease risk assessment and inpatient monitoring in RS patients to optimize outcomes.","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984497","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}

引用次数: 0

Trends and disparities in the location of mortality from myocardial infarction: A 21-year retrospective analysis. 心肌梗死死亡位置的趋势和差异：21年回顾性分析。

IF 1.8

The American journal of the medical sciences Pub Date : 2025-08-23 DOI: 10.1016/j.amjms.2025.08.018

Muhammad Omar Larik, Muhammad Fawad Tahir, Eeshal Fatima, Muhammad Usman Haider, Tanesh Ayyalu, Ahmad Sameed Akram, Hasan Ilyas, Mah I Kan Changez

{"title":"Trends and disparities in the location of mortality from myocardial infarction: A 21-year retrospective analysis.","authors":"Muhammad Omar Larik, Muhammad Fawad Tahir, Eeshal Fatima, Muhammad Usman Haider, Tanesh Ayyalu, Ahmad Sameed Akram, Hasan Ilyas, Mah I Kan Changez","doi":"10.1016/j.amjms.2025.08.018","DOIUrl":"10.1016/j.amjms.2025.08.018","url":null,"abstract":"Background: Despite noteworthy developments and advancements in the field of cardiovascular medicine, myocardial infarction (MI) remains one of the leading causes of mortality worldwide.Aim: To investigate the existence of disparities within MI-related locations of deaths in the United States.Methods: Data on death certificates from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC-WONDER) was utilized to evaluate trends in the locations of MI-related mortality from 1999 to 2020. The following locations were considered: (i) inpatient facilities, (ii) outpatient/emergency facilities, (iii) decedent's home, and (iv) nursing or hospice facilities.Results: A total of 2858,426 MI-related deaths were utilized in this analysis. A steady decline in inpatient mortality was noted, along with a consistent increase in outpatient or emergency room (E.R.) mortality. The male sex was less likely to die in nursing or hospice facilities (OR: 0.44; P < 0.05). Younger individuals (<45 years) were more likely to die in outpatient/E.R. facilities (OR: 5.92; P < 0.05), whereas the elderly (85+ years) were more susceptible to nursing or hospice facilities. Non-Hispanic Black individuals were prone to death in outpatient/E.R. facilities (OR: 1.42; P < 0.05), whereas Non-Hispanic White individuals were more likely to die in nursing or hospice facilities. Additionally, rural areas had a higher risk of death at home (OR: 1.55; P < 0.05), whereas urban areas were more inclined towards inpatient mortality.Conclusions: This analysis identified several disparities and higher risk populations, emphasizing the need for better outreach to deliver practical management strategies in an equitable fashion.","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984441","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}

引用次数: 0

Successful treatment of refractory gastroesophageal reflux-induced chronic cough with vonoprazan: a report of three cases. 伏诺哌赞成功治疗难治性胃食管反流性慢性咳嗽3例报告

IF 1.8

The American journal of the medical sciences Pub Date : 2025-08-22 DOI: 10.1016/j.amjms.2025.08.019

Tong-Yang-Zi Zhang, Lu-Di Fei, Ji-Guang Wu, Yi-Qing Zhu, Wan-Zhen Li, Sheng-Yuan Wang, Xiang-Huai Xu, Li Yu

{"title":"Successful treatment of refractory gastroesophageal reflux-induced chronic cough with vonoprazan: a report of three cases.","authors":"Tong-Yang-Zi Zhang, Lu-Di Fei, Ji-Guang Wu, Yi-Qing Zhu, Wan-Zhen Li, Sheng-Yuan Wang, Xiang-Huai Xu, Li Yu","doi":"10.1016/j.amjms.2025.08.019","DOIUrl":"10.1016/j.amjms.2025.08.019","url":null,"abstract":"Background: Gastroesophageal reflux-induced chronic cough (GERC) is a common cause of chronic cough, with an increasing incidence over the years. Proton-pump inhibitors (PPIs) are the standard treatment for GERC, but some patients exhibit poor response to PPIs. Vonoprazan, a potassium-competitive acid blocker (P-CAB), offers enhanced acid inhibition compared to PPIs and has shown effectiveness in treating GERC. However, its efficacy in refractory GERC cases has not been widely reported.Methods: This report examines three cases of refractory GERC in which patients did not experience significant symptom relief after 8 weeks of PPI treatment. The treatment was switched to vonoprazan to evaluate its effectiveness in alleviating chronic cough symptoms.Results: All three patients demonstrated complete relief from chronic cough after the transition to vonoprazan, indicating its potential effectiveness in cases where PPIs failed to provide sufficient symptom control.Conclusions: Vonoprazan is a promising clinical application in the treatment of refractory GERC.","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984505","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}

引用次数: 0

Reply to "Questions regarding comparison of 24 vs 72-hr octreotide infusion in acute esophageal variceal hemorrhage: A multi-center RCT". 主题：回复“关于24小时与72小时奥曲肽输注治疗急性食管静脉曲张出血的问题：一项多中心RCT”。

IF 1.8

The American journal of the medical sciences Pub Date : 2025-08-21 DOI: 10.1016/j.amjms.2025.08.015

Jad Allam, Don C Rockey

引用次数: 0

Questions regarding comparison of 24vs 72-hr octreotide infusion in acute esophageal variceal hemorrhage: A multi-center RCT. 奥曲肽输注24小时vs 72小时治疗急性食管静脉曲张出血的问题：一项多中心随机对照试验

IF 1.8

The American journal of the medical sciences Pub Date : 2025-08-21 DOI: 10.1016/j.amjms.2025.08.017

Ruyin Jia, Shuyi Chen, Guoshu Xu

引用次数: 0

Activation of aryl hydrocarbon receptor alleviates sepsis by promoting Nuclear Factor Erythroid 2-related Factor 2 expression to inhibit ferroptosis. 激活芳烃受体可通过促进核因子-红系2相关因子- 2的表达，抑制铁下沉，从而减轻脓毒症。

IF 1.8

The American journal of the medical sciences Pub Date : 2025-08-19 DOI: 10.1016/j.amjms.2025.08.013

Hongxuan Liu, Meixia Yang, Zhiyong Zhao, Hongqing Zhang, Chunyan Gao, Liqiong Guo, Shike Hou

{"title":"Activation of aryl hydrocarbon receptor alleviates sepsis by promoting Nuclear Factor Erythroid 2-related Factor 2 expression to inhibit ferroptosis.","authors":"Hongxuan Liu, Meixia Yang, Zhiyong Zhao, Hongqing Zhang, Chunyan Gao, Liqiong Guo, Shike Hou","doi":"10.1016/j.amjms.2025.08.013","DOIUrl":"10.1016/j.amjms.2025.08.013","url":null,"abstract":"Background: Sepsis-induced acute kidney injury (AKI) is a major global public health challenge. Key pathogenic mechanisms include inflammatory responses and renal tubular epithelial cell damage. The aryl hydrocarbon receptor (AhR), a widely expressed protein receptor, has been reported to alleviate AKI upon activation; however, its precise mechanisms remain unclear.Methods: Lipopolysaccharide (LPS) was used to establish sepsis-induced AKI models in vivo and in vitro. Protein expression was analyzed by western blotting, and histological staining was performed to assess tissue injury.Results: AhR activation significantly attenuated LPS-induced AKI and reduced cell death following treatment with the AhR agonist 6-formylindolo[3,2-b]carbazole (FICZ). Mechanistically, FICZ decreased renal accumulation of malondialdehyde (MDA), 4-hydroxynonenal (4-HNE), and Fe²⁺, while upregulating glutathione peroxidase 4 (GPX4) and solute carrier family 7 member 11 (SLC7A11) expression. Furthermore, FICZ promoted AhR nuclear translocation, which subsequently enhanced nuclear factor erythroid 2-related factor 2 (NRF2) nuclear translocation and expression, ultimately mitigating LPS-induced cellular ferroptosis.Conclusions: This study demonstrates that AhR activation enhances NRF2 nuclear translocation and expression, thereby upregulating GPX4 and SLC7A11. This mechanism reduces intracellular lipid peroxide accumulation and suppresses ferroptosis, providing potential therapeutic targets for AKI treatment and translational research.","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984477","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}

引用次数: 0