The American journal of the medical sciences最新文献_第5页

Vasculitis in patients treated with direct oral anticoagulants. 直接口服抗凝剂治疗患者的血管炎。

The American journal of the medical sciences Pub Date : 2024-12-14 DOI: 10.1016/j.amjms.2024.11.013

Giuseppe Famularo, Chiara Dell'Unto

引用次数: 0

The relationship between dietary niacin intake and the incidence of all-cause and cardiovascular mortality among chronic kidney disease patients. 慢性肾病患者饮食烟酸摄入量与全因死亡率及心血管死亡率的关系

The American journal of the medical sciences Pub Date : 2024-12-10 DOI: 10.1016/j.amjms.2024.11.004

Hongxi Chen, Xu He, Junming Fan, Yongjie Mi, Feiyan Li

{"title":"The relationship between dietary niacin intake and the incidence of all-cause and cardiovascular mortality among chronic kidney disease patients.","authors":"Hongxi Chen, Xu He, Junming Fan, Yongjie Mi, Feiyan Li","doi":"10.1016/j.amjms.2024.11.004","DOIUrl":"https://doi.org/10.1016/j.amjms.2024.11.004","url":null,"abstract":"Background: Chronic kidney disease (CKD) is a major cause of human mortality and cardiovascular disease (CVD)-related death. Niacin can treat dyslipidemia and can lower overall cardiovascular event incidence and mortality rates. The present study was designed to clarify the link between dietary consumption of niacin and cardiovascular mortality.Methods: This study enrolled subjects ≥18 years of age from the National Health and Nutrition Examination Survey 2009-2014 and excluded any individuals for whom data regarding their CKD status, dietary niacin intake, or other covariate information was unavailable. Relationships between dietary niacin intake levels and overall or CVD-related mortality among these CKD patients were assessed using univariate and multivariate Cox regression analyses.Results: The study included 1,798 subjects and recorded 514 and 186 instances of all-cause and cardiovascular death, respectively. Males comprised 51.8% of the study cohort, and the mean age of these subjects was 65. Cox proportional hazard model analyses revealed no relationship between dietary niacin intake and all-cause or cardiovascular death risk among the overall CKD patient population (P > 0.05). However, in age-stratified analyses, those subjects <60 years of age exhibiting the highest levels of dietary niacin consumption (≥ 38 mg/day) were found to face a significantly higher risk of all-cause mortality, and this association remained intact in sensitivity analyses.Conclusion: These results do not support any link between the dietary intake of niacin and all-cause or cardiovascular mortality risk among patients with CKD. Age and niacin intake exhibited a significant interaction related to all-cause mortality.","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815339","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

The impact of preoperative depression on in-hospital outcomes in coronary artery bypass grafting: A propensity-matched analysis of National Inpatient Sample from 2015-2020. 术前抑郁对冠状动脉旁路移植术住院结果的影响：2015-2020年全国住院患者样本的倾向匹配分析

The American journal of the medical sciences Pub Date : 2024-12-09 DOI: 10.1016/j.amjms.2024.12.001

Renxi Li, Deyanira J Prastein, Brian G Choi

{"title":"The impact of preoperative depression on in-hospital outcomes in coronary artery bypass grafting: A propensity-matched analysis of National Inpatient Sample from 2015-2020.","authors":"Renxi Li, Deyanira J Prastein, Brian G Choi","doi":"10.1016/j.amjms.2024.12.001","DOIUrl":"10.1016/j.amjms.2024.12.001","url":null,"abstract":"Background: Depression has a high prevalence among patients undergoing coronary artery bypass grafting (CABG). However, there is a scarcity of literature on the association between preoperative depression and CABG outcomes. This study aimed to explore the effects of preoperative major depression disorder (MDD) on in-hospital outcomes following CABG.Methods: Patients who underwent CABG were identified in National Inpatient Sample from the last quarter of 2015 to 2020. Patients were stratified based on the diagnosis of MDD, followed by a 1:3 propensity-score matching of demographics, socioeconomic status, comorbidities, relevant diagnosis, admission status, and hospital characteristics between MDD and non-MDD patients. In-hospital perioperative outcomes, total length of stay (LOS), time from admission to operation, and total hospital charge were compared.Results: There were 908 patients with MDD and 170,830 patients without MDD who underwent CABG. After propensity-score matching, 2,796 non-MDD were matched with all 908 MDD patients. While MDD patients have no difference in-hospital mortality or MACE, they had higher hemorrhage/hematoma (65.97 % vs 60.17 %, p < 0.01) and pacemaker implantation (2.53 % vs 1.43 %, p = 0.04). MDD patients had longer time from admission to operation (3.2 ± 0.1 vs 2.6 ± 0.2 days, p < 0.01), longer total LOS (12.6 ± 0.5 vs 10.5 ± 0.2 days, p < 0.01), and higher total hospital charge (272,255.0 ± 8930.1 vs 230,133.0 ± 3861.1 US dollars, p < 0.01).Conclusion: Potential barriers could exist for MDD patients seeking access to CABG. Preoperative MDD is a risk factor for complications following CABG including hemorrhage/hematoma and pacemaker implantation. Enhanced attention to coagulation function is advisable for MDD patients prior to CABG.","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788320","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

Influencing factors on relapse of sputum pulmonary tuberculosis in elderly diabetes patients. 老年糖尿病患者痰性肺结核复发的影响因素

The American journal of the medical sciences Pub Date : 2024-12-07 DOI: 10.1016/j.amjms.2024.12.006

Jingwei Wang, Zhexia Hu, Zifang Tian, Hui Wu

{"title":"Influencing factors on relapse of sputum pulmonary tuberculosis in elderly diabetes patients.","authors":"Jingwei Wang, Zhexia Hu, Zifang Tian, Hui Wu","doi":"10.1016/j.amjms.2024.12.006","DOIUrl":"10.1016/j.amjms.2024.12.006","url":null,"abstract":"Purpose: This study aimed to explore the factors influencing the relapse of sputum-positive pulmonary tuberculosis (TB) in elderly patients with diabetes.Methods: A total of 187 elderly patients with pulmonary tuberculosis (TB) and bacteriological relapse were selected as participants. These patients were divided into two groups: the TB group (82 cases, TB alone) and the combined group (70 cases, TB complicated with diabetes). Additionally, 90 elderly healthy individuals were enrolled in the healthy group. General data, glycosylated hemoglobin (HbA1c), and fasting blood glucose (FBG) levels were collected from all patients, and sputum smears were analyzed.Results: The combined group exhibited worse outcomes in terms of diabetes duration, lobe cavity, and lesion area compared to the TB group (P < 0.05). Before treatment, the levels of HbA1c and FBG in the combined group were significantly higher than those in the TB group (P < 0.05). After treatment, both groups showed reduced levels of HbA1c and FBG, but the levels remained higher in the combined group compared to the TB group (P < 0.05). Single-factor Logistic regression analysis revealed that the risk factors for TB-positive relapse in diabetes patients complicated with TB included age, diabetes duration, lobe cavity, lesion range, HbA1c, and FBG. Moreover, multivariate Logistic regression analysis identified diabetes duration, lung lobe cavity, lesion area, HbA1c, and FBG as significant risk factors for TB-positive relapse in these patients.Conclusion: Our study revealed that the risk factors for the relapse of sputum-positive TB in elderly diabetes patients include diabetes duration, lobe cavity, lesion area, HbA1c, and FBG.","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142804074","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

The American journal of the medical sciences Pub Date : 2024-12-06 DOI: 10.1016/j.amjms.2024.12.003

Mubashar Karamat, Bansari Patel, Resha Khanal, Mohammad Hamza, Sadaf Fakhra, Ritu Yadav, Neel Navinkumar Patel, Junaid Mir, Nomesh Kumar, Khaled M Harmouch, Masooma Naseem, Yasemin Bahar, Maria Riasat, Harshith Thyagaturu, Yasar Sattar, M Chadi Alraies

{"title":"Sex-related differences in patients with acute myocardial infarction complicated by cardiogenic shock: A systematic review and meta-analysis.","authors":"Mubashar Karamat, Bansari Patel, Resha Khanal, Mohammad Hamza, Sadaf Fakhra, Ritu Yadav, Neel Navinkumar Patel, Junaid Mir, Nomesh Kumar, Khaled M Harmouch, Masooma Naseem, Yasemin Bahar, Maria Riasat, Harshith Thyagaturu, Yasar Sattar, M Chadi Alraies","doi":"10.1016/j.amjms.2024.12.003","DOIUrl":"10.1016/j.amjms.2024.12.003","url":null,"abstract":"Background: This review aims to analyze sex-related differences in patients with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS).Methods: 10 studies were retrieved from PubMed and Embase comparing outcomes between men and women admitted with AMI complicated by CS. Pooled log odds ratios (OR) were calculated for binary outcomes using the Mantel-Haenszel method, and Hedges' g with the inverse-variance method was used for continuous outcomes.Results: The primary endpoints were in-hospital mortality and 30-day mortality. The secondary endpoints were reinfarction rate, length of hospital stay (LOS), requirement of renal replacement therapy (RRT), and stroke (ischemic and hemorrhagic). Males exhibited a lower risk of in-hospital mortality (OR 0.77, 95 % CI 0.69-0.85, I2 = 97 %, p < 0.0001), 30-day mortality (OR 0.69, 95 % CI: 0.61-0.78, I² = 0 %, p < 0.0001) and stroke (OR 0.91, 95 % CI 0.87-0.95, I2 = 36 %, p < 0.0001) compared to females. In contrast, males were more likely to require renal replacement therapy (RRT) (OR 1.27, 95 % CI 1.09-1.48, I2 = 69 % p = 0.0017). However, there were no statistically significant differences between females and males in terms of reinfarction rate (OR 0.88, 95 % CI 0.66-1.18, I2 = 56 %, p = 0.3936) or length of hospital stay during hospitalization (Hedges's g 0.35 days, 95 % CI -0.38-1.07, I2 = 100 %, p = 0.34).Conclusion: Females with AMI and CS have higher in-hospital mortality, 30-day mortality, and stroke risk than men. Men are more likely to require RRT. Further research is needed to understand underlying mechanisms and improve outcomes for both genders.","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796710","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

Relationship between fluid bolus administration and the prognostic role of serum albumin in patients with sepsis. 脓毒症患者液丸给药与血清白蛋白预后的关系。

The American journal of the medical sciences Pub Date : 2024-12-03 DOI: 10.1016/j.amjms.2024.12.002

Gianni Turcato, Lucia Filippi, Arian Zaboli, Paolo Ferretto, Daniela Milazzo, Michael Maggi, Francesca Stefani, Marta Parodi, Massimo Marchetti, Christian J Wiedermann

{"title":"Relationship between fluid bolus administration and the prognostic role of serum albumin in patients with sepsis.","authors":"Gianni Turcato, Lucia Filippi, Arian Zaboli, Paolo Ferretto, Daniela Milazzo, Michael Maggi, Francesca Stefani, Marta Parodi, Massimo Marchetti, Christian J Wiedermann","doi":"10.1016/j.amjms.2024.12.002","DOIUrl":"10.1016/j.amjms.2024.12.002","url":null,"abstract":"Background: Serum albumin plays a pivotal role in the exchange between interstitial and vascular compartments, and reduced levels of this biomarker appear to be associated with negative prognosis in septic patients. The correlation between the volume effect in sepsis therapy and the kinetics of serum albumin is unclear.Aim: To investigate the relationship between serum albumin and fluid bolus in relation to its prognostic role in septic patients.Methods: A single-center prospective observational study conducted from September 2022 to February 2024. All patients with sepsis admitted from the Emergency Department to the Intermediate Medical Care Unit (IMCU) were considered. Post-fluid bolus serum albumin was obtained after fluid bolus. The albumin value was correlated with the volume effect of the fluid bolus, and multivariate models were performed to evaluate its potential independent effect on 30-day mortality.Results: 179 patients were enrolled. Pre-fluid bolus serum albumin was 2.55 g/dL (SD 0.51) with a multivariate OR for 30-day mortality of 1.170 (95 % CI 1.055-1.297, p = 0.003). After the fluid bolus, which resulted in a fluid balance percentage of +23.1 % (SD 7.1) and a mean Fractional Plasma Dilution of -0.48 (SD 0.18), albumin showed a mean decrease of -0.28 g/dL (SD 0.28) with a multivariate OR for 30-day mortality of 1.198 (95 % CI 1.065-1.348, p = 0.003). Post-fluid bolus albumin was negatively correlated with cumulative fluid balance and hemodilution.Conclusions: The volume effect of fluid bolus is correlated with a decrease in serum albumin, and low albumin levels are associated with a high risk of mortality.","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788291","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

Racial disparity among Native Americans in coronary artery bypass grafting: An analysis of national inpatient sample from 2015 to 2020. 美洲原住民在冠状动脉搭桥术中的种族差异：2015 - 2020年全国住院患者样本分析

The American journal of the medical sciences Pub Date : 2024-12-03 DOI: 10.1016/j.amjms.2024.12.004

Renxi Li, Deyanira J Prastein, Brian G Choi

{"title":"Racial disparity among Native Americans in coronary artery bypass grafting: An analysis of national inpatient sample from 2015 to 2020.","authors":"Renxi Li, Deyanira J Prastein, Brian G Choi","doi":"10.1016/j.amjms.2024.12.004","DOIUrl":"10.1016/j.amjms.2024.12.004","url":null,"abstract":"Background: Disparities have been shown in the outcomes of coronary artery bypass grafting (CABG) in racial minorities. Although Native Americans are known to have a higher risk for cardiovascular diseases, the current literature on CABG outcomes for Native Americans remains notably limited, probably due to their limited population size. Thus, this study aimed to investigate racial disparities in CABG outcomes among Native Americans.Methods: Patients who underwent CABG were identified in National Inpatient Sample database from last quarter of 2015 to 2020. A 1:2 propensity score matching was conducted between Native Americans and Caucasians to address preoperative differences in demographics, socioeconomic status, comorbidity, and hospital characteristics. In-hospital outcomes, length of stay (LOS), time from admission to operation, and total hospital charge were compared.Results: There were 905 (0.54 %) Native Americans and 125,983 (74.91 %) Caucasians, where 1,838 Caucasians were matched to all the Native Americans. The in-hospital mortality rate was elevated in Native Americans but was not statistically different (2.87 % vs. 2.23 %, p = 0.43). However, Native Americans had a higher risk of cardiogenic shock (8.51 % vs. 6.2 %, p = 0.03). There was no difference in time from admission to operation (2.55 ± 0.11 vs. 2.73 ± 0.08 days, p = 0.20), LOS (9.82 ± 0.23 vs. 9.95 ± 0.20 days, p = 0.65), or the total hospital charge between the two groups (205,594 ± 5192.8 vs. 213,961 ± 4150.9 US dollars, p = 0.20).Conclusion: Native Americans had a significantly higher risk of cardiogenic shock after CABG. However, in-house mortality and other parameters were not affected. These disparities highlight challenges that Native Americans encounter and emphasize the need for targeted interventions to ensure health equity.","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788290","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

Novel predictor for metabolic syndrome: Para-aortic adipose tissue. 新的代谢综合征预测因子：主动脉旁脂肪组织。

The American journal of the medical sciences Pub Date : 2024-12-01 DOI: 10.1016/j.amjms.2024.11.008

Fahri Çakan, Adem Adar, Sinan Akıncı, Uğur Köktürk, Ertan Akbay, Orhan Önalan

{"title":"Novel predictor for metabolic syndrome: Para-aortic adipose tissue.","authors":"Fahri Çakan, Adem Adar, Sinan Akıncı, Uğur Köktürk, Ertan Akbay, Orhan Önalan","doi":"10.1016/j.amjms.2024.11.008","DOIUrl":"10.1016/j.amjms.2024.11.008","url":null,"abstract":"Background: Metabolic Syndrome (MetS) is an independent risk factor for cardiovascular disease. Perivascular fat depots not only serve as energy storage but also function as endocrine organs. Para-aortic adipose tissue (PAT), a perivascular local adipose tissue, has been suggested to play a role in obesity-mediated vascular disease, and has been associated with MetS components and measures of coronary and abdominal aortic calcification. PAT was previously described and examined using tomography and magnetic resonance imaging. This study aimed to describe the features of para-aortic adipose tissue measured echocardiographically in individuals with MetS.Methods: Patients were divided into two groups according to their MetS status. The hypoechoic space in front of the ascending aorta was considered a PAT on the parasternal long-axis view. Possible covariates for the regression analysis were determined using the DAGitty diagram.Results: A total of 494 patients were enrolled in this study. The PAT was significantly higher in the MetS group [9.6 (6.1/10.6) vs. 6.1 (0.9/9) mm, p < 0.001]. Logistic regression analysis revealed that PAT (OR=2,15, p = 0,003) was significantly associated with MetS. 7.55 mm of PAT has a sensitivity of 65 % and specificity of 65 % [AUC = 0.675, p < 0.001, 95 % CI (0.623-0.726)] in predicting the presence of MetS.Conclusions: Based on the measurements obtained using this newly described modality in transthoracic echocardiography, its relationship with MetS was determined. These results can guide clinicians in diagnosing MetS.","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142776074","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

Risk prediction model for adult intolerance to enteral nutrition feeding - A literature review. 成人肠内营养喂养不耐受风险预测模型——文献综述。

The American journal of the medical sciences Pub Date : 2024-11-30 DOI: 10.1016/j.amjms.2024.11.012

Hui Yang, Jinmei Liu, Hongyan Sun

{"title":"Risk prediction model for adult intolerance to enteral nutrition feeding - A literature review.","authors":"Hui Yang, Jinmei Liu, Hongyan Sun","doi":"10.1016/j.amjms.2024.11.012","DOIUrl":"10.1016/j.amjms.2024.11.012","url":null,"abstract":"Enteral nutrition is an important clinical nutritional supplementation method, especially for adult patients who are unable to eat normally or require additional nutritional support. However, many patients experience intolerance to enteral nutrition, such as delayed gastric emptying, bloating, and diarrhea, which not only affect the patient's nutritional status but also increase the risk of medical complications. In recent years, medical researchers have been dedicated to identifying and analyzing various factors that contribute to enteral nutrition intolerance, including the patient's disease status, nutritional formula, feeding method, and rate. In addition, research is also exploring the establishment of risk prediction models to more accurately predict which patients may develop enteral nutrition intolerance. These models typically combine clinical parameters, biomarkers, and patient individual characteristics, aiming to assist clinicians in better planning and adjusting nutritional treatment plans, thereby reducing the occurrence of intolerance events. This review summarizes the research progress on enteral nutrition intolerance in adult patients, with a focus on the latest developments in intolerance factors and risk prediction models, providing valuable guidance for clinical practice and helping improve patients' nutritional status and overall health.","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142776086","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

Pancreaticopleural fistula: Case report and review of the literature. 胰胸膜瘘：病例报告及文献复习。

The American journal of the medical sciences Pub Date : 2024-11-28 DOI: 10.1016/j.amjms.2024.11.014

Abhinav K Rao, Levi Diggins, Brett Van-Leer Greenberg, James Ravenel, Don C Rockey

引用次数: 0