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Publisher: Elsevier   (Total: 3175 journals)

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Showing 1 - 200 of 3175 Journals sorted alphabetically
A Practical Logic of Cognitive Systems     Full-text available via subscription   (Followers: 9)
AASRI Procedia     Open Access   (Followers: 14)
Academic Pediatrics     Hybrid Journal   (Followers: 30, SJR: 1.402, h-index: 51)
Academic Radiology     Hybrid Journal   (Followers: 22, SJR: 1.008, h-index: 75)
Accident Analysis & Prevention     Partially Free   (Followers: 87, SJR: 1.109, h-index: 94)
Accounting Forum     Hybrid Journal   (Followers: 25, SJR: 0.612, h-index: 27)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 35, SJR: 2.515, h-index: 90)
Achievements in the Life Sciences     Open Access   (Followers: 5)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 6, SJR: 0.338, h-index: 19)
Acta Astronautica     Hybrid Journal   (Followers: 385, SJR: 0.726, h-index: 43)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 2)
Acta Biomaterialia     Hybrid Journal   (Followers: 27, SJR: 2.02, h-index: 104)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription   (Followers: 2)
Acta de Investigación Psicológica     Open Access   (Followers: 3)
Acta Ecologica Sinica     Open Access   (Followers: 8, SJR: 0.172, h-index: 29)
Acta Haematologica Polonica     Free   (Followers: 1, SJR: 0.123, h-index: 8)
Acta Histochemica     Hybrid Journal   (Followers: 3, SJR: 0.604, h-index: 38)
Acta Materialia     Hybrid Journal   (Followers: 241, SJR: 3.683, h-index: 202)
Acta Mathematica Scientia     Full-text available via subscription   (Followers: 5, SJR: 0.615, h-index: 21)
Acta Mechanica Solida Sinica     Full-text available via subscription   (Followers: 9, SJR: 0.442, h-index: 21)
Acta Oecologica     Hybrid Journal   (Followers: 10, SJR: 0.915, h-index: 53)
Acta Otorrinolaringologica (English Edition)     Full-text available via subscription  
Acta Otorrinolaringológica Española     Full-text available via subscription   (Followers: 2, SJR: 0.311, h-index: 16)
Acta Pharmaceutica Sinica B     Open Access   (Followers: 1)
Acta Poética     Open Access   (Followers: 4)
Acta Psychologica     Hybrid Journal   (Followers: 25, SJR: 1.365, h-index: 73)
Acta Sociológica     Open Access  
Acta Tropica     Hybrid Journal   (Followers: 6, SJR: 1.059, h-index: 77)
Acta Urológica Portuguesa     Open Access  
Actas Dermo-Sifiliograficas     Full-text available via subscription   (Followers: 3)
Actas Dermo-Sifiliográficas (English Edition)     Full-text available via subscription   (Followers: 2)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 3, SJR: 0.383, h-index: 19)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 1)
Actualites Pharmaceutiques     Full-text available via subscription   (Followers: 6, SJR: 0.141, h-index: 3)
Actualites Pharmaceutiques Hospitalieres     Full-text available via subscription   (Followers: 3, SJR: 0.112, h-index: 2)
Acupuncture and Related Therapies     Hybrid Journal   (Followers: 6)
Acute Pain     Full-text available via subscription   (Followers: 14)
Ad Hoc Networks     Hybrid Journal   (Followers: 11, SJR: 0.967, h-index: 57)
Addictive Behaviors     Hybrid Journal   (Followers: 15, SJR: 1.514, h-index: 92)
Addictive Behaviors Reports     Open Access   (Followers: 7)
Additive Manufacturing     Hybrid Journal   (Followers: 9, SJR: 1.039, h-index: 5)
Additives for Polymers     Full-text available via subscription   (Followers: 22)
Advanced Cement Based Materials     Full-text available via subscription   (Followers: 3)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 133, SJR: 5.2, h-index: 222)
Advanced Engineering Informatics     Hybrid Journal   (Followers: 11, SJR: 1.265, h-index: 53)
Advanced Powder Technology     Hybrid Journal   (Followers: 16, SJR: 0.739, h-index: 33)
Advances in Accounting     Hybrid Journal   (Followers: 8, SJR: 0.299, h-index: 15)
Advances in Agronomy     Full-text available via subscription   (Followers: 12, SJR: 2.071, h-index: 82)
Advances in Anesthesia     Full-text available via subscription   (Followers: 27, SJR: 0.169, h-index: 4)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 2)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 10, SJR: 1.054, h-index: 35)
Advances in Applied Mechanics     Full-text available via subscription   (Followers: 10, SJR: 0.801, h-index: 26)
Advances in Applied Microbiology     Full-text available via subscription   (Followers: 22, SJR: 1.286, h-index: 49)
Advances In Atomic, Molecular, and Optical Physics     Full-text available via subscription   (Followers: 14, SJR: 3.31, h-index: 42)
Advances in Biological Regulation     Hybrid Journal   (Followers: 4, SJR: 2.277, h-index: 43)
Advances in Botanical Research     Full-text available via subscription   (Followers: 2, SJR: 0.619, h-index: 48)
Advances in Cancer Research     Full-text available via subscription   (Followers: 29, SJR: 2.215, h-index: 78)
Advances in Carbohydrate Chemistry and Biochemistry     Full-text available via subscription   (Followers: 7, SJR: 0.9, h-index: 30)
Advances in Catalysis     Full-text available via subscription   (Followers: 5, SJR: 2.139, h-index: 42)
Advances in Cell Aging and Gerontology     Full-text available via subscription   (Followers: 3)
Advances in Cellular and Molecular Biology of Membranes and Organelles     Full-text available via subscription   (Followers: 12)
Advances in Chemical Engineering     Full-text available via subscription   (Followers: 27, SJR: 0.183, h-index: 23)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10, SJR: 0.665, h-index: 29)
Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 10, SJR: 1.268, h-index: 45)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 28, SJR: 0.938, h-index: 33)
Advances in Colloid and Interface Science     Full-text available via subscription   (Followers: 19, SJR: 2.314, h-index: 130)
Advances in Computers     Full-text available via subscription   (Followers: 14, SJR: 0.223, h-index: 22)
Advances in Dermatology     Full-text available via subscription   (Followers: 15)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 11)
Advances in Digestive Medicine     Open Access   (Followers: 8)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 5)
Advances in Drug Research     Full-text available via subscription   (Followers: 21)
Advances in Ecological Research     Full-text available via subscription   (Followers: 42, SJR: 3.25, h-index: 43)
Advances in Engineering Software     Hybrid Journal   (Followers: 27, SJR: 0.486, h-index: 10)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 7)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 43, SJR: 5.465, h-index: 64)
Advances in Exploration Geophysics     Full-text available via subscription   (Followers: 1)
Advances in Fluorine Science     Full-text available via subscription   (Followers: 7)
Advances in Food and Nutrition Research     Full-text available via subscription   (Followers: 53, SJR: 0.674, h-index: 38)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 15)
Advances in Genetics     Full-text available via subscription   (Followers: 15, SJR: 2.558, h-index: 54)
Advances in Genome Biology     Full-text available via subscription   (Followers: 8)
Advances in Geophysics     Full-text available via subscription   (Followers: 6, SJR: 2.325, h-index: 20)
Advances in Heat Transfer     Full-text available via subscription   (Followers: 21, SJR: 0.906, h-index: 24)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 9, SJR: 0.497, h-index: 31)
Advances in Human Factors/Ergonomics     Full-text available via subscription   (Followers: 22)
Advances in Imaging and Electron Physics     Full-text available via subscription   (Followers: 2, SJR: 0.396, h-index: 27)
Advances in Immunology     Full-text available via subscription   (Followers: 36, SJR: 4.152, h-index: 85)
Advances in Inorganic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 1.132, h-index: 42)
Advances in Insect Physiology     Full-text available via subscription   (Followers: 2, SJR: 1.274, h-index: 27)
Advances in Integrative Medicine     Hybrid Journal   (Followers: 6)
Advances in Intl. Accounting     Full-text available via subscription   (Followers: 3)
Advances in Life Course Research     Hybrid Journal   (Followers: 8, SJR: 0.764, h-index: 15)
Advances in Lipobiology     Full-text available via subscription   (Followers: 1)
Advances in Magnetic and Optical Resonance     Full-text available via subscription   (Followers: 9)
Advances in Marine Biology     Full-text available via subscription   (Followers: 15, SJR: 1.645, h-index: 45)
Advances in Mathematics     Full-text available via subscription   (Followers: 11, SJR: 3.261, h-index: 65)
Advances in Medical Sciences     Hybrid Journal   (Followers: 6, SJR: 0.489, h-index: 25)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 5)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 4, SJR: 1.44, h-index: 51)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 21)
Advances in Molecular and Cellular Endocrinology     Full-text available via subscription   (Followers: 8)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 7, SJR: 0.324, h-index: 8)
Advances in Nanoporous Materials     Full-text available via subscription   (Followers: 3)
Advances in Oncobiology     Full-text available via subscription   (Followers: 1)
Advances in Organ Biology     Full-text available via subscription   (Followers: 1)
Advances in Organometallic Chemistry     Full-text available via subscription   (Followers: 15, SJR: 2.885, h-index: 45)
Advances in Parallel Computing     Full-text available via subscription   (Followers: 6, SJR: 0.148, h-index: 11)
Advances in Parasitology     Full-text available via subscription   (Followers: 5, SJR: 2.37, h-index: 73)
Advances in Pediatrics     Full-text available via subscription   (Followers: 24, SJR: 0.4, h-index: 28)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 10)
Advances in Pharmacology     Full-text available via subscription   (Followers: 15, SJR: 1.718, h-index: 58)
Advances in Physical Organic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 0.384, h-index: 26)
Advances in Phytomedicine     Full-text available via subscription  
Advances in Planar Lipid Bilayers and Liposomes     Full-text available via subscription   (Followers: 3, SJR: 0.248, h-index: 11)
Advances in Plant Biochemistry and Molecular Biology     Full-text available via subscription   (Followers: 7)
Advances in Plant Pathology     Full-text available via subscription   (Followers: 5)
Advances in Porous Media     Full-text available via subscription   (Followers: 5)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 17)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 18, SJR: 1.5, h-index: 62)
Advances in Psychology     Full-text available via subscription   (Followers: 59)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 6, SJR: 0.478, h-index: 32)
Advances in Radiation Oncology     Open Access  
Advances in Small Animal Medicine and Surgery     Hybrid Journal   (Followers: 3, SJR: 0.1, h-index: 2)
Advances in Space Biology and Medicine     Full-text available via subscription   (Followers: 5)
Advances in Space Research     Full-text available via subscription   (Followers: 384, SJR: 0.606, h-index: 65)
Advances in Structural Biology     Full-text available via subscription   (Followers: 5)
Advances in Surgery     Full-text available via subscription   (Followers: 9, SJR: 0.823, h-index: 27)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 29, SJR: 1.321, h-index: 56)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 17)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 13)
Advances in Virus Research     Full-text available via subscription   (Followers: 5, SJR: 1.878, h-index: 68)
Advances in Water Resources     Hybrid Journal   (Followers: 46, SJR: 2.408, h-index: 94)
Aeolian Research     Hybrid Journal   (Followers: 6, SJR: 0.973, h-index: 22)
Aerospace Science and Technology     Hybrid Journal   (Followers: 335, SJR: 0.816, h-index: 49)
AEU - Intl. J. of Electronics and Communications     Hybrid Journal   (Followers: 8, SJR: 0.318, h-index: 36)
African J. of Emergency Medicine     Open Access   (Followers: 6, SJR: 0.344, h-index: 6)
Ageing Research Reviews     Hybrid Journal   (Followers: 10, SJR: 3.289, h-index: 78)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 438, SJR: 1.385, h-index: 72)
Agri Gene     Hybrid Journal  
Agricultural and Forest Meteorology     Hybrid Journal   (Followers: 15, SJR: 2.18, h-index: 116)
Agricultural Systems     Hybrid Journal   (Followers: 31, SJR: 1.275, h-index: 74)
Agricultural Water Management     Hybrid Journal   (Followers: 43, SJR: 1.546, h-index: 79)
Agriculture and Agricultural Science Procedia     Open Access   (Followers: 1)
Agriculture and Natural Resources     Open Access   (Followers: 2)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 56, SJR: 1.879, h-index: 120)
Ain Shams Engineering J.     Open Access   (Followers: 5, SJR: 0.434, h-index: 14)
Air Medical J.     Hybrid Journal   (Followers: 6, SJR: 0.234, h-index: 18)
AKCE Intl. J. of Graphs and Combinatorics     Open Access   (SJR: 0.285, h-index: 3)
Alcohol     Hybrid Journal   (Followers: 11, SJR: 0.922, h-index: 66)
Alcoholism and Drug Addiction     Open Access   (Followers: 9)
Alergologia Polska : Polish J. of Allergology     Full-text available via subscription   (Followers: 1)
Alexandria Engineering J.     Open Access   (Followers: 1, SJR: 0.436, h-index: 12)
Alexandria J. of Medicine     Open Access   (Followers: 1)
Algal Research     Partially Free   (Followers: 9, SJR: 2.05, h-index: 20)
Alkaloids: Chemical and Biological Perspectives     Full-text available via subscription   (Followers: 2)
Allergologia et Immunopathologia     Full-text available via subscription   (Followers: 1, SJR: 0.46, h-index: 29)
Allergology Intl.     Open Access   (Followers: 5, SJR: 0.776, h-index: 35)
Alpha Omegan     Full-text available via subscription   (SJR: 0.121, h-index: 9)
ALTER - European J. of Disability Research / Revue Européenne de Recherche sur le Handicap     Full-text available via subscription   (Followers: 9, SJR: 0.158, h-index: 9)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 48, SJR: 4.289, h-index: 64)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 4)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 4)
Ambulatory Pediatrics     Hybrid Journal   (Followers: 6)
American Heart J.     Hybrid Journal   (Followers: 50, SJR: 3.157, h-index: 153)
American J. of Cardiology     Hybrid Journal   (Followers: 51, SJR: 2.063, h-index: 186)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 44, SJR: 0.574, h-index: 65)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 10, SJR: 1.091, h-index: 45)
American J. of Geriatric Psychiatry     Hybrid Journal   (Followers: 14, SJR: 1.653, h-index: 93)
American J. of Human Genetics     Hybrid Journal   (Followers: 31, SJR: 8.769, h-index: 256)
American J. of Infection Control     Hybrid Journal   (Followers: 26, SJR: 1.259, h-index: 81)
American J. of Kidney Diseases     Hybrid Journal   (Followers: 34, SJR: 2.313, h-index: 172)
American J. of Medicine     Hybrid Journal   (Followers: 42, SJR: 2.023, h-index: 189)
American J. of Medicine Supplements     Full-text available via subscription   (Followers: 3)
American J. of Obstetrics and Gynecology     Hybrid Journal   (Followers: 195, SJR: 2.255, h-index: 171)
American J. of Ophthalmology     Hybrid Journal   (Followers: 62, SJR: 2.803, h-index: 148)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 6)
American J. of Orthodontics and Dentofacial Orthopedics     Full-text available via subscription   (Followers: 6, SJR: 1.249, h-index: 88)
American J. of Otolaryngology     Hybrid Journal   (Followers: 25, SJR: 0.59, h-index: 45)
American J. of Pathology     Hybrid Journal   (Followers: 27, SJR: 2.653, h-index: 228)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 27, SJR: 2.764, h-index: 154)
American J. of Surgery     Hybrid Journal   (Followers: 37, SJR: 1.286, h-index: 125)
American J. of the Medical Sciences     Hybrid Journal   (Followers: 12, SJR: 0.653, h-index: 70)
Ampersand : An Intl. J. of General and Applied Linguistics     Open Access   (Followers: 6)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.066, h-index: 51)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 62, SJR: 0.124, h-index: 9)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 14)
Anales de Cirugia Vascular     Full-text available via subscription  
Anales de Pediatría     Full-text available via subscription   (Followers: 3, SJR: 0.209, h-index: 27)
Anales de Pediatría (English Edition)     Full-text available via subscription  
Anales de Pediatría Continuada     Full-text available via subscription   (SJR: 0.104, h-index: 3)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 4, SJR: 2.577, h-index: 7)
Analytica Chimica Acta     Hybrid Journal   (Followers: 39, SJR: 1.548, h-index: 152)
Analytical Biochemistry     Hybrid Journal   (Followers: 169, SJR: 0.725, h-index: 154)
Analytical Chemistry Research     Open Access   (Followers: 10, SJR: 0.18, h-index: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 11)
Anesthésie & Réanimation     Full-text available via subscription   (Followers: 1)
Anesthesiology Clinics     Full-text available via subscription   (Followers: 22, SJR: 0.421, h-index: 40)
Angiología     Full-text available via subscription   (SJR: 0.124, h-index: 9)
Angiologia e Cirurgia Vascular     Open Access   (Followers: 1)

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Journal Cover American Journal of the Medical Sciences
  [SJR: 0.653]   [H-I: 70]   [12 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 0002-9629
   Published by Elsevier Homepage  [3175 journals]
  • Infective Endocarditis in the Intravenous Drug User: Treatment
           Shortcomings
    • Authors: Alireza Movahed; William Schiavone
      Abstract: Publication date: April 2018
      Source:The American Journal of the Medical Sciences, Volume 355, Issue 4
      Author(s): Alireza Movahed, William Schiavone


      PubDate: 2018-04-15T15:07:15Z
      DOI: 10.1016/j.amjms.2017.11.007
       
  • Heimlich Maneuver-Induced Diaphragmatic Rupture and Hiatal Hernia
    • Authors: Andrew Herman; Abhishek Maiti; Sujith V. Cherian; Rosa M. Estrada-Y-Martin
      Abstract: Publication date: April 2018
      Source:The American Journal of the Medical Sciences, Volume 355, Issue 4
      Author(s): Andrew Herman, Abhishek Maiti, Sujith V. Cherian, Rosa M. Estrada-Y-Martin


      PubDate: 2018-04-15T15:07:15Z
      DOI: 10.1016/j.amjms.2017.11.009
       
  • Can Focal Segmental Glomerulosclerosis Be Differentiated From Minimal
           Change Nephrotic Syndrome Using Biomarkers'
    • Authors: Keiko Hosohata
      Pages: 305 - 306
      Abstract: Publication date: April 2018
      Source:The American Journal of the Medical Sciences, Volume 355, Issue 4
      Author(s): Keiko Hosohata


      PubDate: 2018-04-15T15:07:15Z
      DOI: 10.1016/j.amjms.2018.01.003
       
  • Reduced Forced Expiratory Volume in 1 Second Percentage Predicted Is
           Associated With Diffuse Coronary Atherosclerosis in Hospitalized Patients
           Undergoing Coronary Angiography
    • Authors: Ying Liang; Meng Wang; Xinye Xu; Nan Li; Qingtao Zhou; Bei He
      Pages: 307 - 313
      Abstract: Publication date: April 2018
      Source:The American Journal of the Medical Sciences, Volume 355, Issue 4
      Author(s): Ying Liang, Meng Wang, Xinye Xu, Nan Li, Qingtao Zhou, Bei He
      Background Reduced forced expiratory volume in 1 second percentage (FEV1%) predicted is closely related to cardiovascular mortality. However, evidence regarding the correlation between FEV1% predicted and the severity of coronary atherosclerosis observed on coronary angiography is still limited. We aimed to explore whether a decline in FEV1% predicted was associated with diffuse coronary atherosclerosis in hospitalized patients. Methods A cross-sectional study enrolling hospitalized patients with cardiovascular symptoms undergoing both coronary angiography and lung function testing was conducted. The correlation between FEV1% predicted and angiographic characteristics, including the number of diseased vessels, total number of coronary lesions and Gensini score was analyzed. Results Eighty-five patients were included. Patients with ≥2-vessel disease had significantly lower FEV1% predicted than patients with <2-vessel disease (60.9% ± 19.7% versus 77.2% ± 19.7%, P < 0.001). FEV1% predicted was inversely related to the total number of coronary lesions (β = −0.029, P = 0.002) and Gensini score (β = −0.525, P = 0.006). FEV1% predicted was independently associated with ≥2-vessel disease (odds ratio = 0.961, P = 0.007), total number of coronary lesions (adjusted β = −0.039, P < 0.001) and Gensini score (adjusted β = −0.602, P = 0.005) after adjustment for other traditional cardiovascular risk factors. In the coronary artery disease subgroup, FEV1% predicted maintained an independent and negative relationship with ≥2-vessel disease, total number of coronary lesions and Gensini score. Conclusions Reduced FEV1% predicted was closely associated with multivessel coronary disease and diffuse coronary atherosclerosis in hospitalized patients undergoing coronary angiography.

      PubDate: 2018-04-15T15:07:15Z
      DOI: 10.1016/j.amjms.2017.12.010
       
  • Clinical Significance of Urinary Biomarkers in Patients With Primary Focal
           Segmental Glomerulosclerosis
    • Authors: Qingyan Zhang; Chunming Jiang; Tianfeng Tang; Hengjin Wang; Yangyang Xia; Qiuyuan Shao; Miao Zhang
      Pages: 314 - 321
      Abstract: Publication date: April 2018
      Source:The American Journal of the Medical Sciences, Volume 355, Issue 4
      Author(s): Qingyan Zhang, Chunming Jiang, Tianfeng Tang, Hengjin Wang, Yangyang Xia, Qiuyuan Shao, Miao Zhang
      Background Focal segmental glomerulosclerosis (FSGS) is often accompanied with tubulointerstitial lesion. This study aimed to assess the role of urinary biomarkers in predicting tubulointerstitial lesion and treatment response in FSGS patients. Methods Urinary neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), N-acetyl-β-d-glucosaminidase (NAG) and retinol-binding protein (RBP) were measured in 32 FSGS patients and 22 patients with minimal change nephrotic syndrome. Patients with FSGS were followed up to investigate the value of these markers in predicting treatment response. Results FSGS patients had higher urinary NGAL, NAG and RBP than patients with minimal change nephrotic syndrome with comparable proteinuria. A cutoff value of 15.87ng/mL NGAL demonstrated 87.1% sensitivity and 59.1% specificity for the diagnosis of FSGS, with an area under the receiver operator characteristic curve of 0.801. In FSGS, these markers correlated significantly with the degree of acute tubulointerstitial damage but not with chronic tubulointerstitial lesion. Response to immunosuppressive therapy was significantly different in patients with KIM-1, NAG and RBP levels below and above the cutoff values. Conclusions Urinary NGAL, KIM-1, NAG and RBP are reliable biomarkers of tubulointerstitial lesion in FSGS patients. The measurements of these markers may be useful in diagnosing FSGS, detecting acute tubulointerstitial lesion and predicting treatment response.

      PubDate: 2018-04-15T15:07:15Z
      DOI: 10.1016/j.amjms.2017.12.019
       
  • DASS21: A Useful Tool in the Psychological Profile Evaluation of Dialysis
           Patients
    • Authors: Wen Jiun Liu; Ramli Musa; Thian Fook Chew; Christopher Thiam Seong Lim; Zaki Morad; Mohamad Adam bin Bujang
      Pages: 322 - 330
      Abstract: Publication date: April 2018
      Source:The American Journal of the Medical Sciences, Volume 355, Issue 4
      Author(s): Wen Jiun Liu, Ramli Musa, Thian Fook Chew, Christopher Thiam Seong Lim, Zaki Morad, Mohamad Adam bin Bujang
      Background The effect of dialysis treatment is complex, with both clinical and socio-psychological effects. In this study, we aimed to assess the psychological status of this growing population of end-stage renal disease. Methods Using the Short Form of Depression, Anxiety and Stress Scale (DASS21) questionnaire, we aimed (1) to measure the psychological states of hemodialysis (HD) or peritoneal dialysis (PD) subjects from 15 sites, (2) to compare DASS21 scores between HD and PD, and (3) to identify the associated demographic and medical factors of better psychological states. Results A total of 1,332 were eligible for analysis. Stress (48%) recorded the highest negative emotional states, followed by depression (37%) and anxiety (20%). By multivariate analysis, normal body mass index weight status, religion and absence of coronary artery disease were associated with lower score for depression, anxiety and stress, respectively. Tertiary education was associated with the lowest score in depression and anxiety, whereas HD had a lower score in stress than PD. A younger age was associated with worse DASS21 score of anxiety and stress. Conclusions Obesity, religion and coronary artery disease were significantly associated with all 3 symptoms of depression, anxiety and stress. Older age has a protective effect on anxiety and stress. Further study is needed to evaluate the relationship between these significant factors and each psychological state.

      PubDate: 2018-04-15T15:07:15Z
      DOI: 10.1016/j.amjms.2017.11.015
       
  • Association Between Metabolic Syndrome and Microvascular and Macrovascular
           Disease in Type 2 Diabetic Mellitus
    • Authors: Mei-Yueh Lee; Pi-Jung Hsiao; Jiun-Chi Huang; Wei-Hao Hsu; Szu-Chia Chen; Shyi-Jang Shin
      Pages: 342 - 349
      Abstract: Publication date: April 2018
      Source:The American Journal of the Medical Sciences, Volume 355, Issue 4
      Author(s): Mei-Yueh Lee, Pi-Jung Hsiao, Jiun-Chi Huang, Wei-Hao Hsu, Szu-Chia Chen, Shyi-Jang Shin
      Background The prevalence of metabolic syndrome (MetS) in patients with type 2 diabetes mellitus is high. The aim of this study was to investigate the association between MetS and micro- and macrovascular disease in patients with diabetes and the associated risk factors. Methods The study enrolled 1,986 (854 men and 1,132 women) patients with type 2 diabetes mellitus from outpatient clinics. MetS was defined according to the Adult Treatment Panel III for Asians. Results Of the enrolled patients, 1,363 had MetS and 623 did not. The patients with MetS had significantly higher rates of albuminuria (40.8% vs. 21.8%, P < 0.001), retinopathy (37.9% vs. 28.6%, P < 0.001), coronary artery disease (19.4% vs. 11.6%, P < 0.001), cerebrovascular disease (5.8% vs. 3.2%, P = 0.014), and an ankle-brachial index < 0.9 or ≥ 1.3 (6.1% vs. 3.0%, P = 0.015). Moreover, there were significant trends for stepwise increases in albuminuria, retinopathy, coronary artery disease, cerebrovascular disease and peripheral artery disease corresponding to the number of MetS components (all P for trend < 0.05). Risk factors including MetS, old age, sex, wide pulse pressure, increased hemoglobin A1c, dyslipidemia and decline renal function were associated with micro- and macrovascular disease. Conclusions MetS and the number of its components were significantly associated with micro- and macrovascular disease in the study patients with diabetes and this resulted in a higher risk of cardiovascular disease. Screening programs to allow for early detection and interventions should be established to lower the risk of cardiovascular disease.

      PubDate: 2018-04-15T15:07:15Z
      DOI: 10.1016/j.amjms.2017.12.004
       
  • Using Both Lactic Dehydrogenase Levels and the Ratio of Involved to
           Uninvolved Free Light Chain Levels as Risk Factors Improves Risk
           Assessment in Patients With Newly Diagnosed Multiple Myeloma
    • Authors: Zihua Guo; Huijun Li; Yudi Geng; Jian Cui; Ning Tang; Dengju Li
      Pages: 350 - 356
      Abstract: Publication date: April 2018
      Source:The American Journal of the Medical Sciences, Volume 355, Issue 4
      Author(s): Zihua Guo, Huijun Li, Yudi Geng, Jian Cui, Ning Tang, Dengju Li
      Background This study aimed to evaluate the prognostic value of the ratio of involved to uninvolved free light chain (rFLC) levels and lactic dehydrogenase (LDH) levels in the risk stratification of patients with multiple myeloma (MM). Materials and Methods Clinical data of 283 patients with newly diagnosed MM were retrospectively analyzed. Results In the traditional chemotherapy group, patients with an rFLC < 100 had a better prognosis than those with an rFLC ≥ 100 (40 months versus 6 months, P = 0.022), as did patients with an LDH ≤ upper limit of normal (ULN) compared to those with an LDH > ULN (29 months versus 6 months, P = 0.023). In patients who underwent novel drug-combined therapy, no significant difference was observed between the rFLC < 100 group and the rFLC ≥ 100 group (54 months versus median not reached, P = 0.508). However, patients with an LDH ≤ ULN had a better prognosis than those with an LDH > ULN (60 months versus 21 months, P = 0.004). Using an rFLC ≥ 100 and an LDH ≥ ULN as adverse risk factors, patients were classified into 3 groups: group 1 (no adverse risk factors), group 2 (1 adverse risk factor) and group 3 (2 adverse risk factors). The median overall survival (OS) of groups 1, 2 and 3 was 52 months, 34 months and 15 months, respectively (P = 0.001). Conclusions rFLC and LDH levels were sensitive prognostic factors in MM patients, combining them could improve the risk stratification and treatment choice of patients in clinical practice.

      PubDate: 2018-04-15T15:07:15Z
      DOI: 10.1016/j.amjms.2017.12.003
       
  • Novel Insights Into E3 Ubiquitin Ligase in Cancer Chemoresistance
    • Authors: Li Yang; Jing Chen; Xi Huang; Enfan Zhang; Jingsong He; Zhen Cai
      Pages: 368 - 376
      Abstract: Publication date: April 2018
      Source:The American Journal of the Medical Sciences, Volume 355, Issue 4
      Author(s): Li Yang, Jing Chen, Xi Huang, Enfan Zhang, Jingsong He, Zhen Cai
      Drug resistance can obstruct successful cancer chemotherapy. The ubiquitin-proteasome pathway has emerged as a crucial player that controls steady-state protein levels regulating multiple biological processes, such as cell cycle, cellular proliferation, apoptosis, and DNA damage response, which are involved in oncogenesis, cancer development, prognosis, and drug resistance. E3 ligases perform the final step in the ubiquitination cascade, and determine which protein becomes ubiquitylated by specifically binding the substrate protein. They are promising drug targets thanks to their ability to regulate protein stability and functions. Although patient survival has increased in recent years with the availability of novel agents, chemoresistance remains a major problem in cancer management. E3 ligases attract increasing attention with advances in chemoresistance knowledge. To explore the role of E3 ligase in cancer chemotherapy resistance and the underlying mechanism, we summarize the growing number of E3 ligases and their substrate proteins, which have emerged as crucial players in cancer chemoresistance and targeted therapies.

      PubDate: 2018-04-15T15:07:15Z
      DOI: 10.1016/j.amjms.2017.12.012
       
  • Effects of Alpinetin on Intestinal Barrier Function, Inflammation and
           Oxidative Stress in Dextran Sulfate Sodium-Induced Ulcerative Colitis Mice
           
    • Authors: Yue Tan; Changqing Zheng
      Pages: 377 - 386
      Abstract: Publication date: April 2018
      Source:The American Journal of the Medical Sciences, Volume 355, Issue 4
      Author(s): Yue Tan, Changqing Zheng
      Background Alpinetin is a flavonoid isolated from Alpinia katsumadai Hayata that has demonstrated anti-inflammatory, antibacterial and anti-tumor activities. However, alpinetin has not been widely studied in amelioration of inflammatory bowel disease. The study aimed to investigate the role of alpinetin on intestinal epithelial tight junctions, oxidative stress and Nrf2/HO-1 signaling pathway in dextran sulfate sodium (DSS)-induced ulcerative colitis (UC) in mice. Methods A total of 40 mice were divided into 5 groups (n = 8/group): control group, DSS group (received 3% DSS), and low, medium and high-dose treatment groups (3% DSS + alpinetin 25, 50 and 100mg/kg). The disease activity index (DAI), histological scores, epithelial tight junctions, oxidative stress factors, and Nrf2/HO-1 signaling pathway in the colon were determined. Results Alpinetin improved DAI, colonic shortening, histological scores and myeloperoxidase activity compared with the DSS group. The expression of occludin and zonula occludens-1 were upregulated by alpinetin, whereas the expression of claudin-2 was reduced. Moreover, alpinetin inhibited the level of malondialdehyde, and increased the level of superoxide dismutase. Nrf2/HO-1 signaling pathways were also found to be activated. Conclusion Alpinetin is associated with decreased intestinal inflammation and oxidative stress dose-dependently, and also regulated the expression of tight junctions between cells in UC mice. The findings of our study may shed light on the use of alpinetin in the treatment of UC.

      PubDate: 2018-04-15T15:07:15Z
      DOI: 10.1016/j.amjms.2018.01.002
       
  • Recurrent Pyroglutamic Acidosis Related to Therapeutic Acetaminophen
    • Authors: Hazem M. Alhourani; Aneel Kumar; Lekha K. George; Tahira Sarwar; Barry M. Wall
      Pages: 387 - 389
      Abstract: Publication date: April 2018
      Source:The American Journal of the Medical Sciences, Volume 355, Issue 4
      Author(s): Hazem M. Alhourani, Aneel Kumar, Lekha K. George, Tahira Sarwar, Barry M. Wall
      Pyroglutamic acid, an intermediate in glutathione metabolism, can lead to elevated anion gap metabolic acidosis as rare complication of acetaminophen therapy in adults. Acquired pyroglutamic acidosis has been observed primarily in settings associated with glutathione deficiency. Risk factors for glutathione deficiency include critical illness, chronic liver or kidney disease, advanced age, female gender, alcohol abuse, malnutrition, pregnancy, antiepileptic drugs, and chronic acetaminophen use. Diagnosis of pyroglutamic acidosis requires both the exclusion of common etiologies of increased anion gap metabolic acidosis and a high index of suspicion. Treatment involves discontinuation of acetaminophen, supportive care, and addressing risk factors for glutathione deficiency. The current report describes an ambulatory patient with multiple risk factors for glutathione deficiency, who developed recurrent pyroglutamic acidosis due to acetaminophen use with therapeutic blood levels of acetaminophen.

      PubDate: 2018-04-15T15:07:15Z
      DOI: 10.1016/j.amjms.2017.08.001
       
  • Fatal Hypermagnesemia Due to Laxative Use
    • Authors: Syed Rizwan Bokhari; Ravi Siriki; Federico J. Teran; Vecihi Batuman
      Pages: 390 - 395
      Abstract: Publication date: April 2018
      Source:The American Journal of the Medical Sciences, Volume 355, Issue 4
      Author(s): Syed Rizwan Bokhari, Ravi Siriki, Federico J. Teran, Vecihi Batuman
      We report a case of fatal hypermagnesemia in a 53-year-old woman admitted for acute exacerbation of chronic obstructive pulmonary disease and with a history of chronic constipation treated regularly with magnesium-containing laxatives. On admission, her magnesium level was 2.0mg/dL, which rose to a peak of 10.8mg/dL despite hydration and diuresis in the presence of a normal kidney function. Continuous renal replacement therapy was promptly initiated, which reduced her serum magnesium levels, but her condition continued to deteriorate precipitously progressing to shock leading to oligoanuric renal failure, and she died 2 days later. A review of the literature shows that though rare and often unsuspected, severe hypermagnesemia frequently results in death even in individuals with normal renal function despite renal replacement therapy. In patients with constipation, retention of magnesium-based laxative in the gut apparently serves as a reservoir for continuous magnesium absorption and contributes to mortality

      PubDate: 2018-04-15T15:07:15Z
      DOI: 10.1016/j.amjms.2017.08.013
       
  • Shift: A Medical Studentʼs Reflections on the Practice of Medicine
           and Nursing
    • Authors: Subhi Talal Younes
      Pages: 402 - 403
      Abstract: Publication date: April 2018
      Source:The American Journal of the Medical Sciences, Volume 355, Issue 4
      Author(s): Subhi Talal Younes


      PubDate: 2018-04-15T15:07:15Z
      DOI: 10.1016/j.amjms.2017.01.013
       
  • Prognostic Value of Ventricular Wall Motion Score and Global Registry of
           Acute Coronary Events Score in Acute Mocardial Infarction Patients:
           Methodological Issues
    • Authors: Ahad Ashrafi-Asgarabad; Saeid Safiri
      First page: 404
      Abstract: Publication date: April 2018
      Source:The American Journal of the Medical Sciences, Volume 355, Issue 4
      Author(s): Ahad Ashrafi-Asgarabad, Saeid Safiri


      PubDate: 2018-04-15T15:07:15Z
      DOI: 10.1016/j.amjms.2017.12.018
       
  • Congenital absence of left coronary artery accompanied by premature
           ventricular complexes
    • Authors: Hong-Feng Jin; Xiao-Wei Liu; Chang-Qing Du
      Abstract: Publication date: Available online 1 May 2018
      Source:The American Journal of the Medical Sciences
      Author(s): Hong-Feng Jin, Xiao-Wei Liu, Chang-Qing Du


      PubDate: 2018-05-02T02:49:10Z
      DOI: 10.1016/j.amjms.2018.04.014
       
  • BRCA2 loss-of-function and high sensitivity to cisplatin-based
           chemotherapy in a patient with a pleomorphic soft tissue sarcoma: impact
           of genomic medicine
    • Authors: Camille Tlemsani; Eric Pasmant; Pascaline Boudou-Rouquette; Audrey Bellesoeur; Julien Even; Frédérique Larousserie; Cécile Reyes; David Gentien; Jérôme Alexandre; Michel Vidaud; Philippe Anract; Karen Leroy; François Goldwasser
      Abstract: Publication date: Available online 1 May 2018
      Source:The American Journal of the Medical Sciences
      Author(s): Camille Tlemsani, Eric Pasmant, Pascaline Boudou-Rouquette, Audrey Bellesoeur, Julien Even, Frédérique Larousserie, Cécile Reyes, David Gentien, Jérôme Alexandre, Michel Vidaud, Philippe Anract, Karen Leroy, François Goldwasser
      We report the case of a patient with a BRCA2 germline mutation who developed a localized pleomorphic soft tissue sarcoma of the leg with poor prognostic features. BRCA2 germline mutations were not previously reported to be associated with pleomorphic sarcoma. BRCA2 LOH was found in the tumour, resulting in a complete BRCA2 loss-of-function. BRCA2 deficiency is associated with sensitivity to cisplatin-based chemotherapy in breast and ovarian cancer patients. We used a cisplatin-based chemotherapy. A rapid major partial response was obtained, which allowed a curative and conservative surgical resection of the sarcoma followed by adjuvant irradiation. This case illustrates that sarcoma patients may present unexpected but targetable genetic abnormalities and that BRCA2 loss-of-function may be targetable in sarcoma as it is associated with enhanced sensitivity to cisplatin. Our observation emphasizes the input of genomic medicine in clinical practice, its importance for treatment decisions, and the overlap between constitutional and somatic genetics.

      PubDate: 2018-05-02T02:49:10Z
      DOI: 10.1016/j.amjms.2018.04.015
       
  • Clopidogrel Partially Counteracts Adenosine-5′-Diphosphate Effects on
           Blood Pressure and Renal Hemodynamics and Excretion in Rats
    • Authors: Malwina Monika Roszkowska-Chojecka; Agnieszka Walkowska; Janusz Sadowski; Leszek Dobrowolski
      Abstract: Publication date: Available online 27 April 2018
      Source:The American Journal of the Medical Sciences
      Author(s): Malwina Monika Roszkowska-Chojecka, Agnieszka Walkowska, Janusz Sadowski, Leszek Dobrowolski
      Background Adenosine-5′-diphosphate (ADP) can influence intrarenal vascular tone and tubular transport, partly through activation of purine P2Y12 receptors (P2Y12-R), but their actual in vivo role in regulation of renal circulation and excretion remains unclear. Methods The effects of intravenous ADP infusions of 2–8mg/kg/hour were examined in anesthetized Wistar rats that were untreated or chronically pretreated with clopidogrel, 20mg/kg/24hours, a selective P2Y12-R antagonist. Renal blood flow (transonic probe) and perfusion of the superficial cortex and medulla (laser-Doppler fluxes) were measured, together with urine osmolality (U osm ), diuresis (V), total solute (U osm V), sodium (U Na V) and potassium (U K V) excretion. Results ADP induced a gradual, dose-dependent 15% decrease of mean arterial pressure, a sustained increase of renal blood flow and a 25% decrease in renal vascular resistance. Clopidogrel pretreatment attenuated the mean arterial pressure decrease, and did not significantly alter renal blood flow or renal vascular resistance. Renal medullary perfusion was not affected by ADP whereas Uosm decreased from 1080 ± 125 to 685 ± 75 mosmol/kg H20. There were also substantial significant decreases in U osm V, U Na V and U K V; all these changes were attenuated or abolished by clopidogrel pretreatment. Two-weeks′ clopidogrel treatment decreased V while U osm , U osm V and U Na V increased, most distinctly after 7 days. Acute clopidogrel infusion modestly decreased mean arterial pressure and significantly increased outer- and decreased inner-medullary perfusion. Conclusions Our functional studies show that ADP can cause systemic and renal vasodilation and a decrease in mean arterial pressure, an action at least partly mediated by P2Y12 receptors. We confirmed that these receptors exert tonic action to reduce tubular water reabsorption and urine concentration.

      PubDate: 2018-05-02T02:49:10Z
      DOI: 10.1016/j.amjms.2018.04.013
       
  • Silent Information Regulator 1 Negatively Regulates Atherosclerotic
           Angiogenesis Via Mammalian Target of Rapamycin Complex 1 signaling pathway
           
    • Authors: Runtai Chen; Zhenchun Huang; Junyi Wang; Yingxiao Chen; Yucai Fu; Wei Wang
      Abstract: Publication date: Available online 25 April 2018
      Source:The American Journal of the Medical Sciences
      Author(s): Runtai Chen, Zhenchun Huang, Junyi Wang, Yingxiao Chen, Yucai Fu, Wei Wang
      Background This study aimed to investigate the interactions between silent information regulator 1 (SIRT1) and mammalian target of rapamycin (mTOR) in intraplaque angiogenesis and their potential mechanisms through in vivo and in vitro studies. Methods An atherosclerosis model was established in 12 rabbits on a high-cholesterol diet. The rabbits were equally divided into 3 groups: a control group (high-lipid diet), RAP group (high-lipid diet supplemented with rapamycin), and RAP + NAM group (high-lipid diet supplemented with rapamycin and nicotinamide). At the end of 4 weeks, the area of plaques in the aorta was determined and the protein expression of CD31 and vascular endothelial growth factor (VEGF) was detected through hematoxylin and eosin staining and immunohistochemical staining, respectively. For in vitro study, a hypoxia model was established in human umbilical vein endothelial cells (HUVECs) by using the chemical method (CoCl2). The MTT assay, scratch assay, and tube formation assay were performed to evaluate the proliferation and angiogenesis abilities of HUVECs. Reverse transcription polymerase chain reaction was used to examine the mRNA levels of SIRT1, hypoxia-inducible factor-1α (HIF-1α), mTOR, and p70 ribosomal S6 kinase (p70S6K). Western blotting was used to examine the protein levels of SIRT1, HIF-1α, mTOR, p-mTOR, p-raptor, and p-p70S6K. Results The results of the in vivo study indicated a significant inhibitory effect of rapamycin on plaque size and intraplaque angiogenesis (0.05 ± 0.02 mm2 vs 5.44 ± 0.50 mm2, P < 0.05). This effect was attenuated by nicotinamide (0.76 ± 0.15 mm2 vs 0.05 ± 0.02 mm2, P < 0.05). Compared with the RAP group, CD31- and VEGF-positive vessels were abundant in the RAP + NAM group. The RAP group showed lower expression of p-mTOR, p-p70S6K, and HIF-1α than did the control group (P < 0.05), whereas the RAP + NAM group showed slightly higher expression of these factors than did the RAP group (P < 0.05). Furthermore, in vitro studies revealed that the inhibitory effect of rapamycin on the angiogenic ability of HUVECs and its significant inhibitory effects on the protein level of HIF-1α and the phosphorylation of proteins involved in the mTORC1 pathway, including mTOR, raptor, and p70S6K (P < 0.05), were enhanced by cotreatment with SRT1720 and rapamycin (P < 0.05). In contrast to mTOR and SIRT1, the mRNA levels of p70S6K and HIF-1α were reduced by rapamycin (P < 0.05) and further reduced by cotreatment with SRT1720 and rapamycin. Conclusions The study results indicate that SIRT1 might negatively regulate atherosclerotic angiogenesis via mTORC1 and HIF-1α signaling pathway and cointervention of SIRT1 and mTOR may serve as a crucial therapeutic strategy in cardiovascular medicine.

      PubDate: 2018-05-02T02:49:10Z
      DOI: 10.1016/j.amjms.2018.04.010
       
  • The Beat Goes On: The Story of Five Ageless Cardiac Drugs
    • Authors: Harold Smulyan
      Abstract: Publication date: Available online 25 April 2018
      Source:The American Journal of the Medical Sciences
      Author(s): Harold Smulyan
      This paper traces the history of 5 cardiac drugs – Aspirin, Atropine, Digitalis, Nitroglycerine, and Quinidine - that have been in continuous use for centuries and some for longer. Four of the 5 started life as botanicals and 4 have as also served widely varied functions far removed from their current purposes. Collectively, they have played a role in the history of royalty, religious leaders, assassinations and military campaigns in addition to their place in medical therapy. Their present clinical status has evolved from long term clinical observation without the need for controlled clinical trials, detailed statistical analyses or FDA approvals. This review of their background illustrates the varied means by which markedly different substances from widely separated sources can come together to participate in the management of circulatory disorders.

      PubDate: 2018-05-02T02:49:10Z
      DOI: 10.1016/j.amjms.2018.04.011
       
  • Safely Extubating the Acutely Ill Stroke Patient: By Which Criteria, and
           to What Purpose'
    • Authors: Eric E. Smith; Philippe Couillard
      Abstract: Publication date: Available online 24 April 2018
      Source:The American Journal of the Medical Sciences
      Author(s): Eric E. Smith, Philippe Couillard


      PubDate: 2018-05-02T02:49:10Z
      DOI: 10.1016/j.amjms.2018.04.009
       
  • The Timing of Antibiotic Administration after Triage in the Emergency
           Department may not be Straight Forward!
    • Authors: Steven Clum; Mark Rumbak
      Abstract: Publication date: Available online 12 April 2018
      Source:The American Journal of the Medical Sciences
      Author(s): Steven Clum, Mark Rumbak


      PubDate: 2018-04-15T15:07:15Z
      DOI: 10.1016/j.amjms.2018.04.005
       
  • Modifiable Predictors of In-Hospital Mortality in Patients Undergoing
           Transcatheter Aortic Valve Replacement
    • Authors: Oluwaseun A. Akinseye; Muhammad Shahreyar; Chioma C. Nwagbara; Mannu Nayyar; Salem A. Salem; Mohamed Morsy; Rami N. Khouzam; Uzoma N. Ibebuogu
      Abstract: Publication date: Available online 12 April 2018
      Source:The American Journal of the Medical Sciences
      Author(s): Oluwaseun A. Akinseye, Muhammad Shahreyar, Chioma C. Nwagbara, Mannu Nayyar, Salem A. Salem, Mohamed Morsy, Rami N. Khouzam, Uzoma N. Ibebuogu
      Background Transcatheter aortic valve replacement (TAVR) has become an acceptable therapy for patients with severe aortic valve stenosis at high or prohibitive surgical risk. Attempts are ongoing to validate risk prediction models for in-hospital mortality after TAVR. Our aim was to define modifiable risk factors predictive of in-hospital mortality after TAVR. Methods We identified patients who underwent TAVR from the 2012 database of the National Inpatient Sample. Patients who died during the index hospitalization were compared to those that were successfully discharged. The predictors of in-hospital mortality were analyzed using multivariate logistic regression. Results A total of 1360 patients (mean age 81 ± 8.8 years, whites 80.1%, blacks 3.5%) had TAVR and 68 (5%) died during hospitalization [X 2 (1, n = 1360) = 1101.6, P < 0.001]. The average length of hospital stay was 8.33 ± 6.7 days. The positive predictors of in-hospital mortality in the unadjusted model were comorbidities such as congestive heart failure, coagulopathy, fluid and electrolyte disorder, weight loss, and history of drug abuse. Hypertension was a negative predictor of in-hospital mortality. Following multivariate analysis and adjustment for possible confounders, fluid and electrolyte disorder was the only significant positive predictor of in-hospital mortality (odds ratio [OR] 1.89, CI: 1.11–3.22, P = 0.019). The odds of in-hospital mortality were reduced in patients with hypertension (OR 0.45, CI: 0.26–0.78, P = 0.004). Conclusions Fluid and electrolyte disturbance could be a modifiable predictor of in-hospital mortality following TAVR. Efforts should be geared towards reducing its occurrence in this patient population.

      PubDate: 2018-04-15T15:07:15Z
      DOI: 10.1016/j.amjms.2018.04.008
       
  • Coding and Non-coding Variants in CFH Act Synergistically for Complement
           Activation in Immunoglobulin A Nephropathy
    • Authors: Wei-yi Guo; Qing-zhen Liu; Li Zhu; Zeng-yan Li; Si-jun Meng; Su-fang Shi; Li-jun Liu; Ji-cheng Lv; Ping Hou; Hong Zhang
      Abstract: Publication date: Available online 11 April 2018
      Source:The American Journal of the Medical Sciences
      Author(s): Wei-yi Guo, Qing-zhen Liu, Li Zhu, Zeng-yan Li, Si-jun Meng, Su-fang Shi, Li-jun Liu, Ji-cheng Lv, Ping Hou, Hong Zhang
      Background In immunoglobulin A nephropathy (IgAN), complement activation occurs in both the systemic circulation and in situ (glomerular). A recent IgAN- genome-wide association study (GWAS) identified 1q32 as an IgAN susceptible locus that contained the complement regulatory protein coding gene complement factor H (CFH). Here, we explored the combined genetic effects of coding and non-coding variants in CFH, rs6677604 and rs800292 on complement activation in IgAN. Methods In total, 1194 IgAN patients and 900 healthy controls who were the same as the Beijing Discovery Cohort in our recent IgAN-GWAS were recruited. The genotyping information of rs800292 and rs6677604 were extracted from GWAS data, while the information regarding plasma C3 levels and mesangial C3 deposits were collected from medical records. Results We found both rs800292-GG and rs6677604-GG were risk genotypes for complement activation in IgAN patients, as represented by lower plasma C3 levels in IgAN patients with rs800292-GG and a higher intensity of glomerular C3 deposits in those with rs6677604-GG, respectively. Additionally, IgAN patients with 2 risk genotypes (rs800292-GG and rs6677604-GG) showed a higher degree of complement activation compared to those with no risk genotypes (rs800292-AA/AG and rs6677604-AA/AG), as represented by both lower plasma C3 levels and a higher intensity of glomerular C3 deposits. Moreover, when compared to rs800292 or rs6677604 alone, the combined genetic effects of rs800292 and rs6677604 showed a stronger association with IgAN susceptibility. Conclusions Our findings suggested that both coding and non-coding variants in CFH acted synergistically to regulate the degree of complement activation and thereby contributed to IgAN susceptibility.

      PubDate: 2018-04-15T15:07:15Z
      DOI: 10.1016/j.amjms.2018.04.006
       
  • Acute myocardial infarction patients show strong variations in circulating
           cell free DNA and correlated to clinical manifestations
    • Authors: Jin Xie; Jiawei Yang; Pei Hu
      Abstract: Publication date: Available online 11 April 2018
      Source:The American Journal of the Medical Sciences
      Author(s): Jin Xie, Jiawei Yang, Pei Hu
      Background The objective of the study was to examine the potential use of circulating cell free DNA (cfDNA) in acute myocardial infarction (AMI) patients and correlate it with clinical features. Serial monitoring was conducted to assess any associations to disease. Methods Quantification of cfDNA was performed on 130 cardiovascular disease (CVD) patients as well as 30 healthy volunteers. Serial samplings were conducted using PicoGreen dsDNA assay. Of the 130 patients with CVD, 100 had an AMI and measurements were taken during treatment. Short and medium intervals serial sampling of patients′ blood were undertaken. Results The results were highly correlative of CVD disease status. The mean concentration of cfDNA in patients with AMI was 5 folds higher during the onset of disease compared with healthy volunteers. The cfDNA content was also higher than other patients with CVD. Interestingly, short term monitoring of patients with AMI showed distinct trends that highlighted the severity of the disease and linked to complication events. Medium term monitoring showed 2 distinctive groups with 1 that had their cfDNA returned to basal levels and the other with persistently elevated cfDNA levels. Conclusions Measuring cfDNA in patients with CVD offers an alternative approach to monitor the disease and has potential clinical applications to identify high-risk individuals.

      PubDate: 2018-04-15T15:07:15Z
      DOI: 10.1016/j.amjms.2018.04.007
       
  • Lancisi′s Sign: The giant Venous Wave
    • Authors: Nicolas Johner; Thibault Ronchard; Olivier Boillat; Georgios Giannakopoulos; Florian Rey
      Abstract: Publication date: Available online 7 April 2018
      Source:The American Journal of the Medical Sciences
      Author(s): Nicolas Johner, Thibault Ronchard, Olivier Boillat, Georgios Giannakopoulos, Florian Rey


      PubDate: 2018-04-15T15:07:15Z
      DOI: 10.1016/j.amjms.2018.04.002
       
  • Reduced Stroke after Transcatheter Patent Foramen Ovale Closure – A
           Systematic Review and Meta-analysis
    • Authors: Chikezie Alvarez; Waqas Javed Siddiqui; Sandeep Aggarwal; Syed Farhan Hasni; Shelly Hankins; Howard Eisen
      Abstract: Publication date: Available online 7 April 2018
      Source:The American Journal of the Medical Sciences
      Author(s): Chikezie Alvarez, Waqas Javed Siddiqui, Sandeep Aggarwal, Syed Farhan Hasni, Shelly Hankins, Howard Eisen
      Background Recent randomized control trials have suggested benefit with transcatheter patent foramen ovale closure plus antiplatelet therapy over medical treatment alone for secondary stroke prevention. Material and Methods Data Sources: We searched PubMed and Ovid MEDLINE from the inception until November 10, 2017 for randomized control trials comparing transcatheter patent foramen ovale closure to medical therapy in patients with a patent foramen ovale and a history of cryptogenic stroke. Results Five randomized control trials with 3,627 patients (transcatheter patent foramen ovale closure = 1,829 vs. medical therapy =1,798) were included. There was a decreased number of post transcatheter patent foramen ovale closure strokes compared to the medical therapy arm; 53 vs. 80 strokes (odds ratio [OR] = 0.61, Confidence Interval [CI] = 0.39–0.94, p = 0.03, I2 = 17 %). Transient Ischemic Attacks occurred in 43 patients after transcatheter patent foramen ovale closure vs. 60 patients in the medical therapy group (OR = 0.80, CI = 0.53–1.19, p = 0.26, I2 = 0%). There was a higher incidence of atrial fibrillation in the transcatheter patent foramen ovale closure group, which occurred in 75 patients, compared to 12 patients in the medical therapy group; (OR = 5.23, CI = 2.17–12.59, p = 0.0002, I2 = 43%). There was a trend towards a decreased number of neuropsychiatric events in the transcatheter patent foramen ovale closure closure group compared to the medical therapy group; 42 vs 67 neuropsychiatric events (OR = 0.71, CI = 0.48–1.06, p = 0.09, I2 = 0%). Conclusions and Relevance Transcatheter patent foramen ovale closure plus antiplatelet therapy is superior to medical therapy in patients with a patent foramen ovale and cryptogenic stroke. Patent foramen ovale closure is associated with new-onset atrial fibrillation and a trend towards reduced neuropsychiatric events.

      PubDate: 2018-04-15T15:07:15Z
      DOI: 10.1016/j.amjms.2018.04.004
       
  • Dilemma of Common Bile Duct Dilatation in Opium-addicts: A
           Population-based Study on Prevalence and Clinical Outcome
    • Authors: Amir Reza Radmard; Faezeh Khorasanizadeh; Hossein Poustchi; Soheil Kooraki; Babak Mirminachi; Maryam Sharafkhah; Elham Jafari; Amir Pejman Hashemi Taheri; Rasoul Stoudehmanesh; Mehdi Mohamadnejad; Reza Malekzadeh; Shahin Merat
      Abstract: Publication date: Available online 7 April 2018
      Source:The American Journal of the Medical Sciences
      Author(s): Amir Reza Radmard, Faezeh Khorasanizadeh, Hossein Poustchi, Soheil Kooraki, Babak Mirminachi, Maryam Sharafkhah, Elham Jafari, Amir Pejman Hashemi Taheri, Rasoul Stoudehmanesh, Mehdi Mohamadnejad, Reza Malekzadeh, Shahin Merat
      Background This study aimed to evaluate the association of various opium-related factors with common bile duct (CBD) diameter in opium-addicts in the general population and investigate the clinical importance and long-term outcomes. Materials and Methods In this prospective study, 2400 participants were randomly selected from the Golestan Cohort study. Opium consumption data were recorded. CBD diameter was measured by ultrasound. Transient elastography was performed at enrollment and 3 years later. Participants were followed up for at least 5 years. Results A total of 1599 individuals, aged above 50 years, were enrolled and 167 subjects were opium-addicts. CBD diameter was significantly higher in opium-addicts than controls (mean ± standard deviation:5.54 ± 1.95 vs. 4.74 ± 1.34mm, P < 0.001). This difference was noted with all opium types, but mostly by heroin users (P < 0.001). Ingestion of opium caused greater CBD dilatation than inhalation (coefficient: 1.16; 95% confidence interval (CI) = 0.05–2.27, P = 0.04 vs. coefficient: 0.98; 95% CI = 0.75–1.20, P < 0.001). Transient elastography results did not show any association between fibroscan score change and CBD diameter. No major related malignancy was seen during follow-up. Conclusion This study strengthened the evidence of an association of opium use with increased CBD diameter in a population-based setting without significantly increased risk of pancreaticobiliary malignancies or liver fibrosis. We cautiously suggest that opium-induced CBD dilatation may not require further diagnostic work-up.

      PubDate: 2018-04-15T15:07:15Z
      DOI: 10.1016/j.amjms.2018.04.003
       
  • High prevalence of renal sat wasting without cerebral disease as cause of
           hyponatremia in general medical wards
    • Authors: John K. Maesaka; Louis J. Imbriano; Nobuyuki Miyawaki
      Abstract: Publication date: Available online 7 April 2018
      Source:The American Journal of the Medical Sciences
      Author(s): John K. Maesaka, Louis J. Imbriano, Nobuyuki Miyawaki
      Background The approach to hyponatremia is in a state of flux, especially differentiating syndrome of inappropriate antidiuretic hormone secretion (SIADH) from cerebral-renal salt wasting (RSW) because of diametrically opposite therapeutic goals. Considering RSW can occur without cerebral disease, we determined the prevalence of RSW in the general hospital wards. Methods To differentiate SIADH from RSW, we utilized an algorithm based on fractional excretion (FE) of urate and non-response to saline infusions in SIADH as compared to excretion of dilute urines and prompt increase in serum sodium in RSW. Results Of 62 hyponatremic patients, a) 17 patients (27%) had SIADH, 11 were non-responsive to isotonic saline, and 5 normalized a previously high FEurate after correction of hyponatremia, b) 19 patients (31%) had a reset osmostat (RO) based on normal FEurates and spontaneously excreted dilute urines; c) 24 patients (38%) had RSW, 21 had no clinical evidence of cerebral disease, 19 had saline-induced dilute urines; 2 had undetectable plasma ADH levels when urine was dilute, 10 required 5% dextrose in water to prevent rapid increase in serum sodium, 11 had persistently increased FEurate after correction of hyponatremia and 10 had baseline UNa < 20 mEq/L; d) 1 patient had Addison′s disease with a low FEurate and e) 1 patient (1.6% )had hyponatremia due to hydrochlorothiazide. Conclusions Of the 24 patients with RSW, 21 had no cerebral disease, supporting our proposal to change cerebral to RSW. Application of established pathophysiologic standards and a new algorithm based on determination of FEurate were superior to the volume approach or determination of urinary sodium [UNa] when identifying the cause of hyponatremia.

      PubDate: 2018-04-15T15:07:15Z
      DOI: 10.1016/j.amjms.2018.03.020
       
  • Down-regulation of miR-218–5p Promotes Apoptosis of Human Umbilical Vein
           Endothelial Cells through Regulating HMGB1 in Henoch-Schonlein Purpura
    • Authors: Shao-fei Yu; Wan-yu Feng; Shao-qing Chai; Xiao-bo Meng; Zhong-xia Dou; Hua Zhu
      Abstract: Publication date: Available online 5 April 2018
      Source:The American Journal of the Medical Sciences
      Author(s): Shao-fei Yu, Wan-yu Feng, Shao-qing Chai, Xiao-bo Meng, Zhong-xia Dou, Hua Zhu
      Background Apoptosis of human umbilical vein endothelial cells (HUVECs) plays an important role in the progression of Henoch-Schonlein purpura (HSP). In the present study, we explored the function of miR-218–5p in HUVEC apoptosis and HSP development. Materials and Methods HSP rat model was established and peripheral blood mononuclear cells (PBMC) were isolated. The expression of miR-218–5p and HMGB1 protein in HUVECs was determined by quantitative real-time polymerase chain reaction and western blot, respectively. Cell apoptosis was detected by TUNEL assay. The association between miR-218–5p and HMGB1 was determined by luciferase assay. The endogenous expression of related genes was modulated with recombinant plasmids and cell transfection. Results MiR-218–5p was down-regulated and HMGB1 was up-regulated in vessels of the lower limb of HSP rats and in HUVECs co-cultured in HSP PBMC supernatant. MiR-218–5p negatively regulated HMGB1 by targeting its 3′-UTR. Over-expression of miR-218–5p reversed the increased apoptosis and HMGB1 expression observed in HUVECs co-cultured in PBMC supernatant, while miR-218–5p knockdown showed the opposite outcomes. Furthermore, the miR-218–5p mimic demonstrated an inhibitory effect on the apoptosis of HUVECs co-cultured in PBMC supernatant, which was reversed by over-expression of HMGB1. In HSP rats, over-expression of miR-218–5p attenuated HSP and decreased the level of HMGB1. Conclusions MiR-218–5p attenuated HSP at least partly through regulating HMGB1 expression and affecting the function of HUVECs.

      PubDate: 2018-04-15T15:07:15Z
      DOI: 10.1016/j.amjms.2018.04.001
       
  • The King is Dead: Clark Gable’s Heart Attack
    • Authors: Robert S. Pinals; Harold Smulyan
      Abstract: Publication date: Available online 3 April 2018
      Source:The American Journal of the Medical Sciences
      Author(s): Robert S. Pinals, Harold Smulyan
      Clark Gable was born in a small Ohio mining town and never finished high school. Stage struck as a young man, he did menial jobs while working his way up to movie stardom – his most famous role was in “Gone with the Wind”. He married 5 times. During WWII, he enlisted in the Army Air Corps, flew a few combat missions as a gunner and won the Distinguished Service Cross. Personally, he was intermittently obese, a drinker, smoker, hypertensive and predictably in 1960, he suffered an acute myocardial infarction. His clinical course was benign until the 10th hospital day, when he died suddenly. No resuscitation was attempted. At the time of his death, preventive cardiology, mouth-to-mouth ventilation, closed chest cardiac massage and defibrillation and coronary care units were in their infancy. The history of these and subsequent therapeutic practices are reviewed but Gable died a bit too early for their application.

      PubDate: 2018-04-15T15:07:15Z
      DOI: 10.1016/j.amjms.2018.03.019
       
  • Relationship Between Clinical Features and Computed Tomographic Findings
           in Hospitalized Adult Patients with Community-Acquired Pneumonia
    • Authors: Hyewon Seo; Seung-Ick Cha; Kyung-Min Shin; Jae-Kwang Lim; Seung-Soo Yoo; Shin-Yup Lee; Jaehee Lee; Chang-Ho Kim; Jae-Yong Park
      Abstract: Publication date: Available online 3 April 2018
      Source:The American Journal of the Medical Sciences
      Author(s): Hyewon Seo, Seung-Ick Cha, Kyung-Min Shin, Jae-Kwang Lim, Seung-Soo Yoo, Shin-Yup Lee, Jaehee Lee, Chang-Ho Kim, Jae-Yong Park
      Background Data on the relationship between the clinical and microbiological features of community-acquired pneumonia (CAP) and its computed tomography (CT) findings are limited. The aim of the present study was to investigate the clinic-microbiological features of patients with CAP presenting with ground-glass opacity (GGO) and centrilobular nodules or tree-in-bud pattern on CT images. Methods Patients with CAP that underwent a CT scan at presentation were retrospectively classified using CT findings into consolidation, GGO, and bronchiolitis groups. These 3 groups were compared in terms of clinical parameters and microbiological data. Results Forty (2.4%) patients were allocated to the bronchiolitis group and 46 (2.8%) to the GGO group. The most common pathogen in the bronchiolitis group was Mycoplasma pneumoniae, which was significantly more frequently isolated in this group. The bronchiolitis group was characterized by a higher percentage of cough, a lower percentage of chest pain, and lower blood levels of inflammatory markers. Common pathogens in the GGO group were not significantly different from those in the other 2 groups. Unlike that observed in the consolidation group, complicated parapneumonic effusion or empyema was not observed in the bronchiolitis or GGO group. Outcome variables were similar in the 3 groups. Conclusions The bronchiolitis group was characterized by a higher frequency of M pneumoniae and a less severe form of CAP. The GGO and consolidation groups was similar with respect to causative microorganisms and the clinical features of CAP. No patient in the bronchiolitis or GGO group exhibited complicated parapneumonic effusion or empyema.

      PubDate: 2018-04-15T15:07:15Z
      DOI: 10.1016/j.amjms.2018.03.024
       
  • TMPRSS2-ERG fusion promotes recruitment of regulatory T cells and tumor
           growth in prostate cancer
    • Authors: Lei Shan; Tongyu Ji; Xiang Su; Qichao Shao; Tao Du; Shilong Zhang
      Abstract: Publication date: Available online 30 March 2018
      Source:The American Journal of the Medical Sciences
      Author(s): Lei Shan, Tongyu Ji, Xiang Su, Qichao Shao, Tao Du, Shilong Zhang
      Objective This study was designed to examine the effect of TMPRSS2-ERG fusion on regulatory T cells and tumor growth in prostate cancer, which may provide a new potential therapeutic direction for prostate cancer. Methods The effect of TMPRSS2-ERG fusion on the migration of Treg cells and tumor growth in a mouse model was investigated in vitro and in vivo. TMPRSS2-ERG fusion in biopsy tissues was performed by fluorescence in situ hybridization, and the expression of ERG and Forkhead box P3 was detected by gel electrophoresis, real-time quantitative reverse transcription polymerase chain reaction and Western blot. Enzyme linked immunosorbent assay and flow cytometry were used to analyze transforming growth factor β levels and the number of regulatory T cells, respectively. Finally, the infiltration of regulatory T cells was analyzed by Forkhead box P3 immunohistochemistry. Results Fluorescence in situ hybridization analysis showed that the TMPRSS2-ERG fusion gene was positive in prostate cancer and that the messenger RNA and protein expression of ERG were significantly up-regulated in prostate cancer biopsy tissues. Furthermore, the number of regulatory T cells and the levels of Forkhead box P3 and transforming growth factor β were significantly increased in prostate cancer. TMPRSS2-ERG fusion increased the migration and activation of regulatory T cells in vitro and promoted subcutaneous tumor size and regulatory T cells infiltration in mouse models. Conclusions TMPRSS2-ERG fusion can regulate the recruitment and infiltration of regulatory T cells to promote tumor growth in prostate cancer.

      PubDate: 2018-04-15T15:07:15Z
      DOI: 10.1016/j.amjms.2018.03.023
       
  • Central retinal artery occlusion following hyaluronic acid fillers
           injection
    • Authors: Ji-long Hao; Om Prakash Pant; Cheng-wei Lu
      Abstract: Publication date: Available online 30 March 2018
      Source:The American Journal of the Medical Sciences
      Author(s): Ji-long Hao, Om Prakash Pant, Cheng-wei Lu


      PubDate: 2018-04-15T15:07:15Z
      DOI: 10.1016/j.amjms.2018.03.022
       
  • Ischemic Stroke After Plasmapheresis
    • Authors: Hisham Salahuddin; Ajaz Ahmad Sheikh; Sharmeen Hussaini; Cherian Verghese; Gretchen E. Tietjen
      Abstract: Publication date: Available online 29 March 2018
      Source:The American Journal of the Medical Sciences
      Author(s): Hisham Salahuddin, Ajaz Ahmad Sheikh, Sharmeen Hussaini, Cherian Verghese, Gretchen E. Tietjen
      Plasmapheresis involves the separation of all cellular elements of blood with the help of an extra-corporeal semi-permeable membrane. Even though plasmapheresis is generally considered safe, there have been anecdotal reports of thrombosis related to this exchange. We present two cases of healthy young males developing ischemic strokes within 24 hours of plasmapheresis. A 24-year-old man, Patient A, with a family history of Factor V Leiden mutation presented with right-sided weakness one hour after donating plasma. A hypercoagulable work-up revealed elevations in Factor II. Patient B was a 42-year-old man who presented with a right facial droop, expressive aphasia, and right arm weakness. He had donated plasma 18 hours prior to his presentation. A hypercoagulable work-up revealed elevated levels of von Willebrand factor antigen and high sensitivity C-reactive protein. A procoagulant state induced by plasmapheresis likely increases the risk for symptomatic thrombosis when an underlying thrombophilic state is present in the donor.

      PubDate: 2018-04-15T15:07:15Z
      DOI: 10.1016/j.amjms.2018.03.021
       
  • Quantitating Heart Damage: Part of the Story
    • Authors: L. Julian Haywood
      Abstract: Publication date: Available online 27 March 2018
      Source:The American Journal of the Medical Sciences
      Author(s): L. Julian Haywood


      PubDate: 2018-04-15T15:07:15Z
      DOI: 10.1016/j.amjms.2018.03.016
       
  • Acute Right Ventricular Heart Failure: An Uncommon Case of Thyrotoxicosis
    • Authors: Mariella Faccia; Angelo Porfidia; Massimo Montalto
      Abstract: Publication date: Available online 27 March 2018
      Source:The American Journal of the Medical Sciences
      Author(s): Mariella Faccia, Angelo Porfidia, Massimo Montalto
      Right ventricular failure can be secondary to right ventricular ischemia, pulmonary or tricuspid valvular disease, myocardial shunts, cardiomyopathy, acute and chronic pulmonary hypertension, myocarditis and pericardial disease and it generally carries a poor prognosis. Thyrotoxicosis is a clinical state resulting from high thyroid hormone action in tissues generally due to high thyroid hormone levels. The association between severe hyperthyroidism and high-output heart failure is well-known. Less widespread is the concept that hyperthyroid patients, irrespective of coexisting diseases and through mechanisms not fully elucidated, are at higher risk for pulmonary hypertension and right heart failure, both reversible with the achievement of euthyroidism and associated with a good prognosis. We describe the case of a 44-year-old woman with right ventricular failure and moderate pulmonary hypertension in the setting of thyrotoxicosis, which resolved rapidly after anti-thyroid treatment. The potential mechanisms underlying this condition will also be discussed.

      PubDate: 2018-04-15T15:07:15Z
      DOI: 10.1016/j.amjms.2018.03.017
       
  • The Dust Bowl in the US: An Analysis Based on Current Environmental and
           Clinical Studies
    • Authors: Robert Alexander; Connie Nugent; Kenneth Nugent
      Abstract: Publication date: Available online 26 March 2018
      Source:The American Journal of the Medical Sciences
      Author(s): Robert Alexander, Connie Nugent, Kenneth Nugent
      The Dust Bowl occurred in the Central Plains States in the United States between 1930 and 1940. Prolonged drought, intense recurrent dust storms, and economic depression had profound effects on human welfare. The causes included increased farming on marginal land, poor land management, and prolonged drought. There was a significant increase in the number of measles cases, increased hospitalization for respiratory disorders, and increased infant and overall mortality in Kansas during the Dust Bowl. Recent scientific studies have demonstrated that dust transmits measles virus, influenza virus, and Coccidioides immitis, and that mortality in the United States increases following dust storms with two to three day lag periods. Advances in technology have provided information about the composition of dust and the transfer of microbial pathogens in dust and provide the framework for reducing the economic and health consequences of the next prolonged drought in the United States.

      PubDate: 2018-04-15T15:07:15Z
      DOI: 10.1016/j.amjms.2018.03.015
       
  • A Case of Pseudomelanosis Duodeni in the Setting of Chronic Hydralazine
           Use
    • Authors: Marcus A. Toschi; George A. Salem; Mohammad Madhoun
      Abstract: Publication date: Available online 22 March 2018
      Source:The American Journal of the Medical Sciences
      Author(s): Marcus A. Toschi, George A. Salem, Mohammad Madhoun


      PubDate: 2018-04-15T15:07:15Z
      DOI: 10.1016/j.amjms.2018.03.014
       
  • Association between Aldehyde Dehydrogenase 2 Glu504Lys Polymorphism and
           Alcoholic Liver Disease
    • Authors: Binxia Chang; Shuli Hao; Longyu Zhang; Miaomiao Gao; Ying Sun; Ang Huang; Guangju Teng; Baosen Li; David W. Crabb; Praveen Kusumanchi; Li Wang; Suthat Liangpunsakul; Zhengsheng Zou
      Abstract: Publication date: Available online 20 March 2018
      Source:The American Journal of the Medical Sciences
      Author(s): Binxia Chang, Shuli Hao, Longyu Zhang, Miaomiao Gao, Ying Sun, Ang Huang, Guangju Teng, Baosen Li, David W. Crabb, Praveen Kusumanchi, Li Wang, Suthat Liangpunsakul, Zhengsheng Zou
      Background Only a subset of patients with excessive alcohol use develop alcoholic liver disease (ALD); though the exact mechanism is not completely understood. Once ingested, alcohol is metabolized by 2 key oxidative enzymes, alcohol (ADH) and aldehyde dehydrogenase (ALDH). There are 2 major ALDH isoforms, cytosolic and mitochondrial, encoded by the aldehyde ALDH1 and ALDH2 genes, respectively. The ALDH2 gene was hypothesized to alter genetic susceptibility to alcohol dependence and alcohol-induced liver diseases. The aim of this study is to determine the association between aldehyde dehydrogenase 2 (rs671) glu504lys polymorphism and ALD. Methods ALDH2 genotype was performed in 535 healthy controls and 281 patients with ALD. Results The prevalence of the common form of the SNP rs671, 504glu (glu/glu) was significantly higher in patients with ALD (95.4%) compared to that of controls (73.7%, p<0.0001). Among controls, 23.7% had heterozygous (glu/lys) genotype when compared to 4.6% in those with ALD (OR 0.16, 95%CI 0.09–0.28). The allele frequency for 504lys allele in patients with ALD was 2.3%; compared to 14.5% in healthy controls (OR 0.13, 95%CI 0.07–0.24). Conclusions Patients with ALDH2 504lys variant were less associated with ALD compared to those with ALDH2 504glu using both genotypic and allelic analyses.

      PubDate: 2018-04-15T15:07:15Z
      DOI: 10.1016/j.amjms.2018.03.012
       
  • Kallmann Syndrome with Micropenis
    • Authors: Chia-Po Fu; I-Te Lee
      Abstract: Publication date: Available online 13 March 2018
      Source:The American Journal of the Medical Sciences
      Author(s): Chia-Po Fu, I-Te Lee


      PubDate: 2018-03-19T06:19:29Z
      DOI: 10.1016/j.amjms.2018.03.011
       
  • Erythropoietin enhances bone repair effects via the hypoxia-inducible
           factor signal pathway in glucocorticoid-induced osteonecrosis of the
           femoral head
    • Authors: Donghai Li; Qinsheng Hu; Gang Tan; Xiaowei Xie; Zhouyuan Yang; Pengde Kang
      Abstract: Publication date: Available online 8 March 2018
      Source:The American Journal of the Medical Sciences
      Author(s): Donghai Li, Qinsheng Hu, Gang Tan, Xiaowei Xie, Zhouyuan Yang, Pengde Kang
      Background This study aimed to determine whether erythropoietin could repair glucocorticoid-induced osteonecrosis of the femoral head after the systemic or local administration of recombinant human erythropoietin. Materials and Methods Gelatin microspheres were used to load recombinant human erythropoietin for local delivery. Forty-eight Wistar rats were included in the glucocorticoid-induced osteonecrosis of the femoral head model and randomly divided into the placebo, systemic erythropoietin, and local erythropoietin groups. Eight weeks later, all rats were killed and their tissues were subjected to radiographic, histological, histometric, quantitative polymerase chain reaction, and western blot analyses. Results Our results show that the use of recombinant human erythropoietin increased bone volume, trabecular number, trabecular thickness, and trabecular separation compared with the placebo. Erythropoietin administration significantly improved the expression of runt-related transcription factor 2, alkaline phosphates, hypoxia-inducible factor-1α, and vascular endothelial growth factor in the femoral head. We also found that the local injection of erythropoietin could better mediate hypoxia-inducible factor-1α–controlled osteogenic and angiogenic factor expression and better repair the glucocorticoid-induced osteonecrosis of the femoral head. Conclusions The use of recombinant human erythropoietin exerted effects on improving the bone structures in glucocorticoid-induced osteonecrosis of the femoral head and up-regulated the expression of runt-related transcription factor 2, alkaline phosphates, hypoxia-inducible factor-1α, and vascular endothelial growth factor. It provided a novel idea that erythropoietin administration could repair glucocorticoid-induced osteonecrosis of the femoral head by improving bone formation and angiogenesis and may be associated with the hypoxia-inducible factor-1α pathway. The sequential delivery of erythropoietin from gelatin microspheres seems worth recommending.

      PubDate: 2018-03-19T06:19:29Z
      DOI: 10.1016/j.amjms.2018.03.010
       
  • Coronary Atherosclerosis: What Do The Lungs Have To Do With It'
    • Authors: Rugheed Ghadban; Kul Aggarwal
      Abstract: Publication date: Available online 7 February 2018
      Source:The American Journal of the Medical Sciences
      Author(s): Rugheed Ghadban, Kul Aggarwal


      PubDate: 2018-03-19T06:19:29Z
      DOI: 10.1016/j.amjms.2018.01.010
       
  • Letter to editor
    • Authors: Xinyi Zhu; Li Xiang; Tao You; Weiting Xu
      Abstract: Publication date: Available online 2 February 2018
      Source:The American Journal of the Medical Sciences
      Author(s): Xinyi Zhu, Li Xiang, Tao You, Weiting Xu


      PubDate: 2018-02-05T13:55:04Z
      DOI: 10.1016/j.amjms.2017.12.017
       
 
 
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