Journal of the National Medical Association最新文献

{"title":"Why men don't talk about domestic violence.","authors":"David E Myles","doi":"10.1016/j.jnma.2024.10.005","DOIUrl":"https://doi.org/10.1016/j.jnma.2024.10.005","url":null,"abstract":"<p><p>A personal anecdote highlighting the myriad myths and misconceptions about why men don't often report domestic violence and the steps that society can take to ensure that everyone who has experienced such violence gets the resources and support they need.</p>","PeriodicalId":94375,"journal":{"name":"Journal of the National Medical Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634142","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 association between heart failure and systemic inflammatory response index: A cross-sectional study.","authors":"Yu Zheng, Zixing Nie, Yifan Zhang, Zhihua Guo","doi":"10.1016/j.jnma.2024.10.007","DOIUrl":"https://doi.org/10.1016/j.jnma.2024.10.007","url":null,"abstract":"<p><strong>Background: </strong>The systemic inflammatory response index (SIRI) is a recently developed composite index that assesses the entire extent of inflammation in the body, closely linked to heart failure (HF). This study aimed to evaluate the potential association between SIRI and HF.</p><p><strong>Methods: </strong>The cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) database from 2001 to 2018. SIRI is calculated based on the counts of monocytes, neutrophils, and lymphocytes. A weighted multiple-variable linear regression model examined the correlation between SIRI and HF. Using restrained cubic splines explored the nonlinear relationship between the two, and the robustness of the results was verified by subgroup analysis and interaction tests.</p><p><strong>Results: </strong>Our study included 30,294 participants, 814 of whom were diagnosed with HF and 29,480 with non-HF. The multiple linear regression analysis showed that SIRI was positively correlated with HF (OR = 1.66; 95 % CI, 1.21, 2.29) and that there was no nonlinear relationship between the two. This relationship persisted in subgroup analyses.</p><p><strong>Conclusions: </strong>The results indicate a linear positive correlation between SIRI and HF. Further extensive prospective studies are needed to validate these findings.</p>","PeriodicalId":94375,"journal":{"name":"Journal of the National Medical Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633838","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 cross sectional analysis of residents by race/ethnicity and specialty from 2020-2023.","authors":"William H Swain, Alec J Calac, Luis R Gasca, Benjamin R Harris, Alice Gallo de Moraes","doi":"10.1016/j.jnma.2024.10.006","DOIUrl":"https://doi.org/10.1016/j.jnma.2024.10.006","url":null,"abstract":"<p><strong>Background: </strong>Minorities are underrepresented in all areas of medical education relative to the United States general population, and minority physicians are more likely to practice in disadvantaged areas and in primary care settings. Many individual and structural factors contribute to this discrepancy. We aimed to demonstrate how resident race/ethnicity representation differs across the various resident specialties.</p><p><strong>Methods: </strong>We used publically available data from the Association of American Medical College's Report on Residents data series and averaged the four academic years from 2019 to 2020 through 2022-2023. We then calculated the odds ratio (OR) of self-reported race/ethnicity (alone and in combination) in thirty-four specialties.</p><p><strong>Results: </strong>Across the four-year study period, there were, on average, 147026 unduplicated resident trainees. The average number of duplicated residents by self-identified ethnic category (alone and in combination) include: American Indian or Alaska Native (839, 0.6%), Asian (31627, 21.5%), Black or African American (7935, 5.4%), Hispanic, Latino, or of Spanish Origin (10900, 7.4%), Native Hawaiian or Other Pacific Islander (296, 0.2%), White (76289, 51.9%), Other (4879, 3.3%), Unknown (522, 0.4%), and Non-US Citizens (23914, 16.3%). Across race/ethnicity, there are differences in ORs of representation in different specialties. Key findings include high representation in Public Health and Preventative Medicine by Black and African American (OR=3.7) and Native Hawaiian (OR=2.6) residents, and Family Medicine in Native Americans (OR=1.9), Native Hawaiian (OR=1.7), Black (OR=1.5), and Hispanic (OR=1.3) residents. Psychiatry also had high ORs of representation in minority residents.</p><p><strong>Conclusion: </strong>This study illustrates relative resident ethnic representation across training specialties. Minorities ethnicities were more likely to be represented in primary care and public health domains. This has implications for creating a physician workforce suitable to serve the United States Population.</p>","PeriodicalId":94375,"journal":{"name":"Journal of the National Medical Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633188","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":"Identification of immune-related hub genes in chronic obstructive pulmonary disease.","authors":"Lingyu Zhang, Liwei Zuo","doi":"10.1016/j.jnma.2024.10.008","DOIUrl":"https://doi.org/10.1016/j.jnma.2024.10.008","url":null,"abstract":"<p><strong>Objective: </strong>As a prevalent persistent respiratory disease, chronic obstructive pulmonary disease (COPD) is featured by airflow limitation and chronic inflammation. This study focused on the identification of immune-related hub genes in COPD.</p><p><strong>Methods: </strong>We employed the GSE38974 dataset to analyze differentially expressed genes (DEGs) of COPD. Then, we obtained COPD immune-related DEGs (COPD-IMDEGs) based on the intersection of DEGs and immune-related genes. Subsequently, we carried out Gene ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses on COPD-IMDEGs. We established a protein-protein interaction network based on COPD-IMDEGs. The hub genes were determined by utilizing the Maximal Clique Centrality method. We utilized receiver operating characteristic (ROC) curves to analyze the clinical significance of hub genes in COPD. In addition, potential drugs targeting hub genes were predicted based on interactions between hub gene-corresponding proteins and drugs.</p><p><strong>Results: </strong>A total of 45 COPD-IMDEGs were obtained through differential analysis. Enrichment analyses showed that COPD-IMDEGs were associated with cytokines, growth factors, and receptor ligands. Ten COPD-IMDEGs were identified as hub genes. As shown by ROC curves, these genes had potential value in identifying COPD patients. Drug prediction results showed that simvastatin and other drugs targeted hub genes.</p><p><strong>Conclusion: </strong>This study analyzed the potential biological functions enriched by COPD-IMDEGs, identified ten genes as biological markers for diagnosing COPD, and predicted potential drugs for treating COPD.</p>","PeriodicalId":94375,"journal":{"name":"Journal of the National Medical Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142694092","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":"Lp(a) and risk of cardiovascular disease - A review of existing evidence and emerging concepts.","authors":"Manasa Jasti, Sabrina Islam, Nathan Steele, Kendra Ivy, Willibroad Maimo, Ijeoma Isiadinso","doi":"10.1016/j.jnma.2023.11.009","DOIUrl":"10.1016/j.jnma.2023.11.009","url":null,"abstract":"<p><p>Cardiovascular disease (CVD) remains the leading cause of death among adults in the United States. There has been significant advancement in the diagnosis and treatment of atherosclerotic cardiovascular disease (ASCVD) and its underlying risk factors. In certain populations, there remains a significant residual risk despite adequate lowering of low-density lipoprotein cholesterol (LDL-C) and control of traditional risk factors. This has led to an interest in research to identify additional risk factors that contribute to atherosclerotic cardiovascular disease. Elevated lipoprotein (a) [Lp(a)] has been identified as an independent risk factor contributing to an increased risk for CVD. There are also ethnic and racial disparities in Lp(a) inheritance that need to be understood. This paper reviews the current literature on lipoprotein a, proposed mechanisms of actions for cardiovascular disease, recommendations for testing, and the current and emerging therapies for lowering Lp(a).</p>","PeriodicalId":94375,"journal":{"name":"Journal of the National Medical Association","volume":" ","pages":"508-516"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139033144","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 beacon of hope program: Co-creating effective, measurable solutions for health equity.","authors":"Priscilla Pemu, Celia Maxwell, Rajbir Singh, Jaydutt Vadgama, Shahanaz Arjumand, Linda Armstrong","doi":"10.1016/j.jnma.2024.09.002","DOIUrl":"10.1016/j.jnma.2024.09.002","url":null,"abstract":"","PeriodicalId":94375,"journal":{"name":"Journal of the National Medical Association","volume":" ","pages":"566-568"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142485017","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":"Updates in pharmacotherapy of obesity.","authors":"Amie A Ogunsakin, Tomilola I Olakunde, Moses D Fehintola, Ifeoluwa Malmberg, Akinwale Olakunde, Ayotunde O Dokun","doi":"10.1016/j.jnma.2024.09.004","DOIUrl":"10.1016/j.jnma.2024.09.004","url":null,"abstract":"<p><p>Obesity is now recognized as a chronic, progressive condition requiring early intervention and long-term management to achieve health benefits and improve metabolic risk factors. The main objective of obesity pharmacotherapy is weight loss and weight loss maintenance. There is increasing acceptance of anti-obesity medications as an adjunct to lifestyle modifications and/or surgery. In recent years there has been an evolution in management approach and pharmacologic options for treatment. As a result, there is increased focus on the efficacy and safety of these agents. We provide a historical perspective, review of recent studies on anti-obesity medication outcomes showing efficacy, potential side effects and promising therapies in development.</p>","PeriodicalId":94375,"journal":{"name":"Journal of the National Medical Association","volume":" ","pages":"576-587"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549948","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":"Special Issue on Cardiovascular Health in African-Americans and More.","authors":"Marie L Borum","doi":"10.1016/j.jnma.2024.10.004","DOIUrl":"https://doi.org/10.1016/j.jnma.2024.10.004","url":null,"abstract":"","PeriodicalId":94375,"journal":{"name":"Journal of the National Medical Association","volume":"116 5","pages":"465"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142690269","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":"Impact of Etonogestrel-releasing contraceptive implant use in cisgender women with Sickle cell disease.","authors":"Milena Bastos Brito, Andrea Queiroz Vilas Boas, Anelise Maria Nicolau Silva, Flávia Pimentel Miranda, Carolina Brabec Barreto Matos, Oziemile Silva Santos, Tais Paiva da Costa","doi":"10.1016/j.jnma.2024.09.003","DOIUrl":"10.1016/j.jnma.2024.09.003","url":null,"abstract":"<p><strong>Background: </strong>Sickle cell disease is a hereditary hemolytic anemia that exposes women to increased health risks especially in pregnancy, with serious implications for the woman and fetus. Acute pain episodes can occur multiple times per month and result in reduction of quality of life and disruption of her life.</p><p><strong>Objective: </strong>To assess the clinical, including pain and metabolic parameters of women with sickle cell disease using etonogestrel-releasing contraceptive implants.</p><p><strong>Methods: </strong>Women with sickle cell disease, aged 18-40 years, with reports of pain crises in the preceding 3 months were included and followed up for 12 months. Blood samples were collected to evaluate the blood count, reticulocytes, liver profile (alkaline phosphatase, gamma-glutamyl transferase, alanine aminotransferase, aspartate aminotransferase, and total bilirubin and its fractions), lipid profile, and lactate dehydrogenase levels before and 6 and 12 months after implant insertion. The following clinical variables were analyzed every 3 months: bleeding pattern, blood pressure, weight, body mass index, pain intensity (assessed using a visual analogic scale (VAS) from 0 to 10), and frequency of pain crises.</p><p><strong>Results: </strong>Twenty-three women completed the study. There were no differences in laboratory variables between baseline and 6 and 12 months after implant insertion. Similarly, clinical variables did not differ, except for pain intensity (VAS pre-insertion = 8 vs. VAS 12 months post insertion = 4; p = 0.005) and frequency of pain crises (pre-insertion = 6 vs. 12 days/month post insertion = 0; p = 0.000).</p><p><strong>Conclusions: </strong>Etonogestrel-releasing contraceptive implants were associated with a reduction in the intensity and frequency of pain crises in women with sickle cell disease. Moreover, it was safety among these population due to no changes in laboratory parameters during the first 12 months of use.</p>","PeriodicalId":94375,"journal":{"name":"Journal of the National Medical Association","volume":" ","pages":"569-575"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142485016","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":"COVID-19 vaccine uptake and intention of Black adults: A county-wide analysis of an online survey.","authors":"Krissy Moehling Geffel, Harika P Dyer, Andrea D Casas, Stephanie N Christian-Afflu, Dara D Méndez, Tiffany L Gary-Webb","doi":"10.1016/j.jnma.2024.07.007","DOIUrl":"10.1016/j.jnma.2024.07.007","url":null,"abstract":"<p><strong>Background: </strong>There are demonstrated racial inequities in coronavirus 2019 (COVID-19) disease burden, and the initial vaccine rollout did not equitably address these disparities.</p><p><strong>Methods: </strong>We conducted analyses of a national Facebook survey restricted to Black adult residents of Allegheny County, Pennsylvania for the period of May 2021 to January 2022. We assessed the associations between demographics, health status, social normative context, perceived racial discrimination, and beliefs about COVID-19 mitigation strategies on vaccine uptake and intention and compared reasons reported for vaccine hesitancy, and vaccine non-intention among the unvaccinated. Multivariable logistic regression was conducted on a subset of unvaccinated respondents to explore variables associated with vaccine intent.</p><p><strong>Results: </strong>Over 85 % of 1,552 respondents were vaccinated against COVID-19 at the time of the survey. Compared to the unvaccinated, vaccinated respondents were older and more highly educated (P < 0.001), more likely to have at least one chronic health condition (P = 0.03) and had a stronger social normative context in support of vaccination (P < 0.001). Vaccinated respondents also reported greater personal adherence to wearing face masks when out in public and were more likely to report positive perceptions of the effectiveness of mitigation strategies (e.g., face masks) towards preventing COVID-19 transmission (P < 0.001). Unvaccinated respondents were more likely to report intention to be vaccinated if they felt that face masks were very effective in the prevention of COVID-19 compared to those who felt this mitigation strategy was only moderately/slightly/not at all effective (OR: 4.52; 95 % CI: 1.23-16.59; P = 0.02) and if they did not report mistrust in the government or COVID-19 vaccines compared to those reporting mistrust (OR: 7.72; 95 % CI: 1.34-44.64; P = 0.02).</p><p><strong>Conclusion: </strong>COVID-19 vaccination levels were high among Black adult residents of Allegheny County who responded to the survey. Future efforts should continue to strive towards addressing reasons for mistrust with focused attention from healthcare institutions and the government on increasing their trustworthiness, alongside employment of evidence-based strategies to increase vaccination rates. Additionally, efforts should continue to engage unvaccinated and vaccine hesitant persons' perspectives to inform ongoing health equity interventions.</p>","PeriodicalId":94375,"journal":{"name":"Journal of the National Medical Association","volume":" ","pages":"526-538"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142020096","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}