for Journals by Title or ISSN
for Articles by Keywords
help

Publisher: Elsevier   (Total: 3162 journals)

 A  B  C  D  E  F  G  H  I  J  K  L  M  N  O  P  Q  R  S  T  U  V  W  X  Y  Z  

        1 2 3 4 5 6 7 8 | Last   [Sort by number of followers]   [Restore default list]

Showing 1 - 200 of 3162 Journals sorted alphabetically
A Practical Logic of Cognitive Systems     Full-text available via subscription   (Followers: 9)
AASRI Procedia     Open Access   (Followers: 15)
Academic Pediatrics     Hybrid Journal   (Followers: 34, SJR: 1.655, CiteScore: 2)
Academic Radiology     Hybrid Journal   (Followers: 23, SJR: 1.015, CiteScore: 2)
Accident Analysis & Prevention     Partially Free   (Followers: 97, SJR: 1.462, CiteScore: 3)
Accounting Forum     Hybrid Journal   (Followers: 26, SJR: 0.932, CiteScore: 2)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 37, SJR: 1.771, CiteScore: 3)
Achievements in the Life Sciences     Open Access   (Followers: 5)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 7)
Acta Astronautica     Hybrid Journal   (Followers: 411, SJR: 0.758, CiteScore: 2)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 2)
Acta Biomaterialia     Hybrid Journal   (Followers: 27, SJR: 1.967, CiteScore: 7)
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: 10, SJR: 0.18, CiteScore: 1)
Acta Haematologica Polonica     Free   (Followers: 1, SJR: 0.128, CiteScore: 0)
Acta Histochemica     Hybrid Journal   (Followers: 3, SJR: 0.661, CiteScore: 2)
Acta Materialia     Hybrid Journal   (Followers: 252, SJR: 3.263, CiteScore: 6)
Acta Mathematica Scientia     Full-text available via subscription   (Followers: 5, SJR: 0.504, CiteScore: 1)
Acta Mechanica Solida Sinica     Full-text available via subscription   (Followers: 9, SJR: 0.542, CiteScore: 1)
Acta Oecologica     Hybrid Journal   (Followers: 12, SJR: 0.834, CiteScore: 2)
Acta Otorrinolaringologica (English Edition)     Full-text available via subscription  
Acta Otorrinolaringológica Española     Full-text available via subscription   (Followers: 3, SJR: 0.307, CiteScore: 0)
Acta Pharmaceutica Sinica B     Open Access   (Followers: 1, SJR: 1.793, CiteScore: 6)
Acta Poética     Open Access   (Followers: 4, SJR: 0.101, CiteScore: 0)
Acta Psychologica     Hybrid Journal   (Followers: 28, SJR: 1.331, CiteScore: 2)
Acta Sociológica     Open Access   (Followers: 1)
Acta Tropica     Hybrid Journal   (Followers: 6, SJR: 1.052, CiteScore: 2)
Acta Urológica Portuguesa     Open Access  
Actas Dermo-Sifiliograficas     Full-text available via subscription   (Followers: 3, SJR: 0.374, CiteScore: 1)
Actas Dermo-Sifiliográficas (English Edition)     Full-text available via subscription   (Followers: 2)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 3, SJR: 0.344, CiteScore: 1)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 1)
Actualites Pharmaceutiques     Full-text available via subscription   (Followers: 6, SJR: 0.19, CiteScore: 0)
Actualites Pharmaceutiques Hospitalieres     Full-text available via subscription   (Followers: 3)
Acupuncture and Related Therapies     Hybrid Journal   (Followers: 6)
Acute Pain     Full-text available via subscription   (Followers: 14, SJR: 2.671, CiteScore: 5)
Ad Hoc Networks     Hybrid Journal   (Followers: 11, SJR: 0.53, CiteScore: 4)
Addictive Behaviors     Hybrid Journal   (Followers: 16, SJR: 1.29, CiteScore: 3)
Addictive Behaviors Reports     Open Access   (Followers: 8, SJR: 0.755, CiteScore: 2)
Additive Manufacturing     Hybrid Journal   (Followers: 9, SJR: 2.611, CiteScore: 8)
Additives for Polymers     Full-text available via subscription   (Followers: 22)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 150, SJR: 4.09, CiteScore: 13)
Advanced Engineering Informatics     Hybrid Journal   (Followers: 11, SJR: 1.167, CiteScore: 4)
Advanced Powder Technology     Hybrid Journal   (Followers: 17, SJR: 0.694, CiteScore: 3)
Advances in Accounting     Hybrid Journal   (Followers: 8, SJR: 0.277, CiteScore: 1)
Advances in Agronomy     Full-text available via subscription   (Followers: 14, SJR: 2.384, CiteScore: 5)
Advances in Anesthesia     Full-text available via subscription   (Followers: 28, SJR: 0.126, CiteScore: 0)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 2)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 10, SJR: 0.992, CiteScore: 1)
Advances in Applied Mechanics     Full-text available via subscription   (Followers: 11, SJR: 1.551, CiteScore: 4)
Advances in Applied Microbiology     Full-text available via subscription   (Followers: 24, SJR: 2.089, CiteScore: 5)
Advances In Atomic, Molecular, and Optical Physics     Full-text available via subscription   (Followers: 14, SJR: 0.572, CiteScore: 2)
Advances in Biological Regulation     Hybrid Journal   (Followers: 4, SJR: 2.61, CiteScore: 7)
Advances in Botanical Research     Full-text available via subscription   (Followers: 2, SJR: 0.686, CiteScore: 2)
Advances in Cancer Research     Full-text available via subscription   (Followers: 33, SJR: 3.043, CiteScore: 6)
Advances in Carbohydrate Chemistry and Biochemistry     Full-text available via subscription   (Followers: 8, SJR: 1.453, CiteScore: 2)
Advances in Catalysis     Full-text available via subscription   (Followers: 5, SJR: 1.992, CiteScore: 5)
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: 0.156, CiteScore: 1)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10, SJR: 0.713, CiteScore: 1)
Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 10, SJR: 1.316, CiteScore: 2)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 29, SJR: 1.562, CiteScore: 3)
Advances in Colloid and Interface Science     Full-text available via subscription   (Followers: 19, SJR: 1.977, CiteScore: 8)
Advances in Computers     Full-text available via subscription   (Followers: 14, SJR: 0.205, CiteScore: 1)
Advances in Dermatology     Full-text available via subscription   (Followers: 15)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 12)
Advances in Digestive Medicine     Open Access   (Followers: 9)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 5)
Advances in Drug Research     Full-text available via subscription   (Followers: 24)
Advances in Ecological Research     Full-text available via subscription   (Followers: 44, SJR: 2.524, CiteScore: 4)
Advances in Engineering Software     Hybrid Journal   (Followers: 28, SJR: 1.159, CiteScore: 4)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 7)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 46, SJR: 5.39, CiteScore: 8)
Advances in Exploration Geophysics     Full-text available via subscription   (Followers: 1)
Advances in Fluorine Science     Full-text available via subscription   (Followers: 9)
Advances in Food and Nutrition Research     Full-text available via subscription   (Followers: 58, SJR: 0.591, CiteScore: 2)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 16)
Advances in Genetics     Full-text available via subscription   (Followers: 16, SJR: 1.354, CiteScore: 4)
Advances in Genome Biology     Full-text available via subscription   (Followers: 8, SJR: 12.74, CiteScore: 13)
Advances in Geophysics     Full-text available via subscription   (Followers: 6, SJR: 1.193, CiteScore: 3)
Advances in Heat Transfer     Full-text available via subscription   (Followers: 23, SJR: 0.368, CiteScore: 1)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 12, SJR: 0.749, CiteScore: 3)
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: 0.193, CiteScore: 0)
Advances in Immunology     Full-text available via subscription   (Followers: 36, SJR: 4.433, CiteScore: 6)
Advances in Inorganic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 1.163, CiteScore: 2)
Advances in Insect Physiology     Full-text available via subscription   (Followers: 2, SJR: 1.938, CiteScore: 3)
Advances in Integrative Medicine     Hybrid Journal   (Followers: 7, SJR: 0.176, CiteScore: 0)
Advances in Intl. Accounting     Full-text available via subscription   (Followers: 3)
Advances in Life Course Research     Hybrid Journal   (Followers: 8, SJR: 0.682, CiteScore: 2)
Advances in Lipobiology     Full-text available via subscription   (Followers: 1)
Advances in Magnetic and Optical Resonance     Full-text available via subscription   (Followers: 8)
Advances in Marine Biology     Full-text available via subscription   (Followers: 18, SJR: 0.88, CiteScore: 2)
Advances in Mathematics     Full-text available via subscription   (Followers: 11, SJR: 3.027, CiteScore: 2)
Advances in Medical Sciences     Hybrid Journal   (Followers: 6, SJR: 0.694, CiteScore: 2)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 5)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 4, SJR: 1.158, CiteScore: 3)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 23)
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: 0.182, CiteScore: 0)
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: 17, SJR: 1.875, CiteScore: 4)
Advances in Parallel Computing     Full-text available via subscription   (Followers: 7, SJR: 0.174, CiteScore: 0)
Advances in Parasitology     Full-text available via subscription   (Followers: 5, SJR: 1.579, CiteScore: 4)
Advances in Pediatrics     Full-text available via subscription   (Followers: 24, SJR: 0.461, CiteScore: 1)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 12)
Advances in Pharmacology     Full-text available via subscription   (Followers: 16, SJR: 1.536, CiteScore: 3)
Advances in Physical Organic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 0.574, CiteScore: 1)
Advances in Phytomedicine     Full-text available via subscription  
Advances in Planar Lipid Bilayers and Liposomes     Full-text available via subscription   (Followers: 3, SJR: 0.109, CiteScore: 1)
Advances in Plant Biochemistry and Molecular Biology     Full-text available via subscription   (Followers: 9)
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: 18)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 20, SJR: 0.791, CiteScore: 2)
Advances in Psychology     Full-text available via subscription   (Followers: 64)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 6, SJR: 0.371, CiteScore: 1)
Advances in Radiation Oncology     Open Access   (Followers: 1, SJR: 0.263, CiteScore: 1)
Advances in Small Animal Medicine and Surgery     Hybrid Journal   (Followers: 3, SJR: 0.101, CiteScore: 0)
Advances in Space Biology and Medicine     Full-text available via subscription   (Followers: 6)
Advances in Space Research     Full-text available via subscription   (Followers: 397, SJR: 0.569, CiteScore: 2)
Advances in Structural Biology     Full-text available via subscription   (Followers: 5)
Advances in Surgery     Full-text available via subscription   (Followers: 11, SJR: 0.555, CiteScore: 2)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 34, SJR: 2.208, CiteScore: 4)
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: 2.262, CiteScore: 5)
Advances in Water Resources     Hybrid Journal   (Followers: 46, SJR: 1.551, CiteScore: 3)
Aeolian Research     Hybrid Journal   (Followers: 6, SJR: 1.117, CiteScore: 3)
Aerospace Science and Technology     Hybrid Journal   (Followers: 342, SJR: 0.796, CiteScore: 3)
AEU - Intl. J. of Electronics and Communications     Hybrid Journal   (Followers: 8, SJR: 0.42, CiteScore: 2)
African J. of Emergency Medicine     Open Access   (Followers: 6, SJR: 0.296, CiteScore: 0)
Ageing Research Reviews     Hybrid Journal   (Followers: 11, SJR: 3.671, CiteScore: 9)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 454, SJR: 1.238, CiteScore: 3)
Agri Gene     Hybrid Journal   (Followers: 1, SJR: 0.13, CiteScore: 0)
Agricultural and Forest Meteorology     Hybrid Journal   (Followers: 17, SJR: 1.818, CiteScore: 5)
Agricultural Systems     Hybrid Journal   (Followers: 31, SJR: 1.156, CiteScore: 4)
Agricultural Water Management     Hybrid Journal   (Followers: 41, SJR: 1.272, CiteScore: 3)
Agriculture and Agricultural Science Procedia     Open Access   (Followers: 3)
Agriculture and Natural Resources     Open Access   (Followers: 3)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 57, SJR: 1.747, CiteScore: 4)
Ain Shams Engineering J.     Open Access   (Followers: 5, SJR: 0.589, CiteScore: 3)
Air Medical J.     Hybrid Journal   (Followers: 6, SJR: 0.26, CiteScore: 0)
AKCE Intl. J. of Graphs and Combinatorics     Open Access   (SJR: 0.19, CiteScore: 0)
Alcohol     Hybrid Journal   (Followers: 11, SJR: 1.153, CiteScore: 3)
Alcoholism and Drug Addiction     Open Access   (Followers: 10)
Alergologia Polska : Polish J. of Allergology     Full-text available via subscription   (Followers: 1)
Alexandria Engineering J.     Open Access   (Followers: 1, SJR: 0.604, CiteScore: 3)
Alexandria J. of Medicine     Open Access   (Followers: 1, SJR: 0.191, CiteScore: 1)
Algal Research     Partially Free   (Followers: 11, SJR: 1.142, CiteScore: 4)
Alkaloids: Chemical and Biological Perspectives     Full-text available via subscription   (Followers: 2)
Allergologia et Immunopathologia     Full-text available via subscription   (Followers: 1, SJR: 0.504, CiteScore: 1)
Allergology Intl.     Open Access   (Followers: 5, SJR: 1.148, CiteScore: 2)
Alpha Omegan     Full-text available via subscription   (SJR: 3.521, CiteScore: 6)
ALTER - European J. of Disability Research / Revue Européenne de Recherche sur le Handicap     Full-text available via subscription   (Followers: 9, SJR: 0.201, CiteScore: 1)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 51, SJR: 4.66, CiteScore: 10)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 4, SJR: 1.796, CiteScore: 4)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 4, SJR: 1.108, CiteScore: 3)
Ambulatory Pediatrics     Hybrid Journal   (Followers: 6)
American Heart J.     Hybrid Journal   (Followers: 50, SJR: 3.267, CiteScore: 4)
American J. of Cardiology     Hybrid Journal   (Followers: 54, SJR: 1.93, CiteScore: 3)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 45, SJR: 0.604, CiteScore: 1)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 10)
American J. of Geriatric Psychiatry     Hybrid Journal   (Followers: 14, SJR: 1.524, CiteScore: 3)
American J. of Human Genetics     Hybrid Journal   (Followers: 34, SJR: 7.45, CiteScore: 8)
American J. of Infection Control     Hybrid Journal   (Followers: 27, SJR: 1.062, CiteScore: 2)
American J. of Kidney Diseases     Hybrid Journal   (Followers: 35, SJR: 2.973, CiteScore: 4)
American J. of Medicine     Hybrid Journal   (Followers: 47)
American J. of Medicine Supplements     Full-text available via subscription   (Followers: 3, SJR: 1.967, CiteScore: 2)
American J. of Obstetrics and Gynecology     Hybrid Journal   (Followers: 210, SJR: 2.7, CiteScore: 4)
American J. of Ophthalmology     Hybrid Journal   (Followers: 65, SJR: 3.184, CiteScore: 4)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 5, SJR: 0.265, CiteScore: 0)
American J. of Orthodontics and Dentofacial Orthopedics     Full-text available via subscription   (Followers: 6, SJR: 1.289, CiteScore: 1)
American J. of Otolaryngology     Hybrid Journal   (Followers: 25, SJR: 0.59, CiteScore: 1)
American J. of Pathology     Hybrid Journal   (Followers: 28, SJR: 2.139, CiteScore: 4)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 28, SJR: 2.164, CiteScore: 4)
American J. of Surgery     Hybrid Journal   (Followers: 38, SJR: 1.141, CiteScore: 2)
American J. of the Medical Sciences     Hybrid Journal   (Followers: 12, SJR: 0.767, CiteScore: 1)
Ampersand : An Intl. J. of General and Applied Linguistics     Open Access   (Followers: 7)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.144, CiteScore: 3)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 62, SJR: 0.138, CiteScore: 0)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 17, SJR: 0.411, CiteScore: 1)
Anales de Cirugia Vascular     Full-text available via subscription  
Anales de Pediatría     Full-text available via subscription   (Followers: 3, SJR: 0.277, CiteScore: 0)
Anales de Pediatría (English Edition)     Full-text available via subscription  
Anales de Pediatría Continuada     Full-text available via subscription  
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 5, SJR: 4.849, CiteScore: 10)
Analytica Chimica Acta     Hybrid Journal   (Followers: 42, SJR: 1.512, CiteScore: 5)
Analytical Biochemistry     Hybrid Journal   (Followers: 176, SJR: 0.633, CiteScore: 2)
Analytical Chemistry Research     Open Access   (Followers: 11, SJR: 0.411, CiteScore: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 11)
Anesthésie & Réanimation     Full-text available via subscription   (Followers: 2)
Anesthesiology Clinics     Full-text available via subscription   (Followers: 23, SJR: 0.683, CiteScore: 2)
Angiología     Full-text available via subscription   (SJR: 0.121, CiteScore: 0)
Angiologia e Cirurgia Vascular     Open Access   (Followers: 1, SJR: 0.111, CiteScore: 0)
Animal Behaviour     Hybrid Journal   (Followers: 196, SJR: 1.58, CiteScore: 3)

        1 2 3 4 5 6 7 8 | Last   [Sort by number of followers]   [Restore default list]

Journal Cover
American Journal of the Medical Sciences
Journal Prestige (SJR): 0.767
Citation Impact (citeScore): 1
Number of Followers: 12  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0002-9629
Published by Elsevier Homepage  [3162 journals]
  • Acknowledgment of Reviewers
    • Abstract: Publication date: December 2018Source: The American Journal of the Medical Sciences, Volume 356, Issue 6Author(s):
       
  • Dystrophic Calcifications in Chronic Venous Insufficiency
    • Abstract: Publication date: Available online 14 November 2018Source: The American Journal of the Medical SciencesAuthor(s): Rukma Govindu
       
  • Changes in fecal calprotectin after rifaximin treatment in patients with
           non-constipated irritable bowel syndrome
    • Abstract: Publication date: Available online 13 November 2018Source: The American Journal of the Medical SciencesAuthor(s): Seok-Hoon Lee, Cho-Rong Kim, Kyu-Nam Kim BackgroundFecal calprotectin, an indicator of colonic inflammation, is associated with non-constipated irritable bowel syndrome. Rifaximin is an antibiotic used to treat non-constipated irritable bowel syndrome. We performed a retrospective review of patient charts to investigate the changes in fecal calprotectin levels and intestinal symptoms following treatment with rifaximin in patients with non-constipated irritable bowel syndrome with elevated fecal calprotectin.MethodsThis study included 198 patients presenting with gastrointestinal complaints consistent with Rome III criteria for irritable bowel syndrome. We treated them with rifaximin for 4 - 12 weeks, until fecal calprotectin levels were normalized, and divided these into 4-, 8-, and 12-week groups according to the treatment period. Fecal calprotectin levels and gastrointestinal symptoms were assessed following rifaximin therapy.ResultsA total of 162 subjects achieved normalized fecal calprotectin values. Of these, most patients who used rifaximin for 8 or 12 weeks showed a significant improvement in gastrointestinal symptoms by the fourth week of treatment, and gradually improved symptoms after 4 weeks. Fecal calprotectin levels were reduced with concomitant improvement of clinical symptoms. In addition, 36 patients who had elevated fecal calprotectin even after 12 weeks of rifaximin treatment showed a gradual reduction in gastrointestinal symptoms and fecal calprotectin during the course of treatment for 12 weeks.ConclusionsThese findings suggest that fecal calprotectin might be a useful biomarker for measuring the effect of rifaximin therapy in non-constipated irritable bowel syndrome patients with elevated fecal calprotectin values.
       
  • Coronary Artery Embolism: Two Case Reports and a Review of the Literature
    • Abstract: Publication date: Available online 10 November 2018Source: The American Journal of the Medical SciencesAuthor(s): Philip S. Vendittelli, Bassent Botros, Howard S. Rosman, Viren Govindaraju, Anwar Zaitoun, Tariq S. Marroush Coronary embolism (CE) is an uncommon and unique cause of acute myocardial infarction. In this report, we review 216 cases of CE including 2 new cases from our institution. The mean patient age was 52.5 years and 62% of the patients were males. Chest pain was the most common presenting symptom followed by dyspnea, and the most commonly affected vessel was the left anterior descending artery. Leading etiologies of the embolus were atrial fibrillation, septic emboli and iatrogenic causes. Treatment approaches varied with thrombus aspiration being used in 30% of cases. In-hospital mortality rate was 36% and 13% of the cases were complicated by cerebrovascular accident. CE is a unique pathology that leads to acute myocardial infarction. It portends a high mortality rate and requires a high level of suspicion as symptoms may be misleading. Further research is needed in order to improve recognition and management and to lower associated mortality.
       
  • Case Report: Can a high-grade neuroendocrine carcinoma be functional'
    • Abstract: Publication date: Available online 10 November 2018Source: The American Journal of the Medical SciencesAuthor(s): Christopher Graham, Aman Chauhan, Lowell AnthonyABSTRACTWe present a rare high-grade, functional, neuroendocrine carcinoma of the pancreas secreting vasoactive intestinal peptide (VIP). This case is unique given the tumor's aggressive features and high Ki-67 index while also secreting functional hormones, which is unusual in high-grade neuroendocrine tumors. Our patient initially presented with diarrhea and was found to have a 4.7 × 3.1 × 3.3cm pancreatic mass with diffuse hepatic metastasis staining positive for VIP, chromogranin A and synaptophysin. She was initially underscored as Grade 2 neuroendocrine tumor due to low mitosis, but subsequently restaged based on Ki-67 index as a Grade 3 neuroendocrine carcinoma. She unfortunately was not a candidate of chemotherapy at that time. We conclude that high-grade neuroendocrine tumors have the potential to secrete active peptide hormones. We therefore recommend that neuroendocrine tumors with aggressive features be biopsied and assessed for Ki-67 activity and mitosis regardless if they are functional tumors, with goal for early initiation of chemotherapy.
       
  • Pseudocholinesterase Deficiency: What the gastroenterologist needs to know
    • Abstract: Publication date: Available online 10 November 2018Source: The American Journal of the Medical SciencesAuthor(s): Alejandro Robles, Majd Michael, Richard McCallumABSTRACTPseudocholinesterase deficiency is a rare genetic as well as an acquired disorder that affects the body's ability to metabolize choline esters such as succinylcholine and mivacurium. It can be inherited as an autosomal recessive trait, occurring in approximately 1 in 3,200 to 1 in 5,000 people. In most cases of pseudocholinesterase deficiency, no signs or symptoms of the condition exists. It is first suspected after a prolonged recovery from paralysis following general anesthesia in which succinylcholine or mivacurium are administered. We emphasize the importance of obtaining a detailed history prior to any endoscopic intervention or surgery requiring monitored anesthesia care or general anesthesia. In addition, a family history of anesthesia complications may help identify patients at risk. This article examines a case of a patient who underwent a successful endoscopic pneumatic dilation under general anesthesia for the treatment of achalasia but was subsequently admitted to the intensive care unit, requiring mechanical ventilator support, for 18 hours. The patient made a complete recovery and was subsequently discharged home with no further complications. This case stimulated a review of this entity and we provide recommendations relevant to all proceduralist and anesthesia staff, as well as all personnel involved in procedures.
       
  • Transplantation of endothelial progenitor cells attenuates
           lipopolysaccharide-induced lung injury via inhibiting the inflammatory
           secretion of neutrophils in rats
    • Abstract: Publication date: Available online 2 November 2018Source: The American Journal of the Medical SciencesAuthor(s): Mei Mao, Lei Hao, Yi Wang, Qiu-qian LiuABSTRACTBackgroundEndothelial progenitor cells (EPCs) are special types of stem cells and are a potential novel therapeutic approach in acute lung injury (ALI). Transplantation of EPCs can ameliorate the inflammatory state by reducing adhesion and exudation of inflammatory cells. However, the mechanism underlying the effect of EPCs on inflammatory response modulation remains unclear. The aim of the present study was to investigate the effect of EPCs on the modulation of neutrophils in vitro and in vivo.MethodsEPCs were cocultured with neutrophils after lipopolysaccharide stimulation in vitro or transplanted into ALI rats, and neutrophil inflammatory mediators including tumor necrosis factor-α, interleukin-1β, neutrophil elastase, myeloperoxidase, and matrix metalloproteinases-9 were detected by enzyme-linked immunosorbent assay (ELISAs), an myeloperoxidase detection kits, reverse transcription-polymerase chain reaction (RT-PCR) and western blotting.ResultsThe results showed that EPCs significantly downregulated the expression of inflammatory mediators when cocultured with neutrophils in vitro or in vivo.ConclusionsThese findings demonstrated that EPCs contributed to lung injury in ALI rats by downregulating neutrophil inflammatory mediators.
       
  • Iron Deficiency Anemia Associated with Acid-Modifying Medications: Two
           Cases and Literature Review
    • Abstract: Publication date: Available online 1 November 2018Source: The American Journal of the Medical SciencesAuthor(s): Ramya Deepthi Vinnakota, Allan S. Brett Iron deficiency anemia is often listed among potential adverse effects of gastric acid-suppressive medications, given that gastric acidity promotes intestinal absorption of non-heme iron. Additionally, the antacid calcium carbonate can inhibit iron absorption. However, there is little direct clinical evidence that proton-pump inhibitors, histamine-2 receptor antagonists, or calcium carbonate cause iron deficiency anemia. Most case reports have had substantial limitations (e.g., minimal follow-up and presence of other causes of iron deficiency), and retrospective cohort studies have lacked sufficient patient-specific detail to make strong causal inferences. We present two cases – both with detailed, prospective 10-year follow-up – in which combinations of proton-pump inhibitors, histamine-2 receptor antagonists and calcium carbonate were clearly associated with development of iron deficiency anemia. Overt iron-deficiency anemia is probably uncommon in patients who use acid-modifying medications and who have no other conditions that predispose to iron deficiency. Nevertheless, clinicians should be aware of this potential complication, given widespread use of these agents.
       
  • Complete Heart Block from Chronic Marijuana Use: A Word of Caution Against
           Medical Marijuana
    • Abstract: Publication date: Available online 30 October 2018Source: The American Journal of the Medical SciencesAuthor(s): Priyam Mithawala, Priyank Shah, Edward KoomsonABSTRACTMarijuana is the most commonly used illicit drug in the world. Over the last decade, the potency of marijuana has increased tremendously. Its use is associated with harmful health consequences including adverse cardiovascular effects, such as arrhythmias, myocardial infarction, cardiomyopathy, and stroke. It has been reported to cause bradycardia. This report describes the case of a 51-year-old female with no significant past medical history who presented with complete heart block due to chronic marijuana use, requiring a permanent pacemaker. To our knowledge, this is the first reported case of complete heart block due to chronic marijuana use. Advanced conduction system abnormalities can be a potential complication of chronic marijuana use, which the physicians need to be aware of. With increasing push for medical marijuana, physicians are likely to encounter more of such cases.
       
  • Preoperative serum 25-hydroxyvitamin D level, a risk factor for
           postoperative cognitive dysfunction in elderly subjects undergoing total
           joint arthroplasty
    • Abstract: Publication date: Available online 30 October 2018Source: The American Journal of the Medical SciencesAuthor(s): Bin Gao, Binbin Zhu, Chunxian Wu BackgroundPostoperative cognitive dysfunction (POCD) is a very common postoperative complication occurring mainly after high-risk surgery, especially in the elderly individuals. This study aimed to investigate potential risk factors for POCD in elderly patients after total joint arthroplasty (TJA).MethodsA total of 257 eligible elderly patients (≥65 years) who were scheduled for elective TJA for osteoarthritis with general anesthesia were enrolled. An experienced psychiatrist was invited to evaluate the cognitive function at baseline (1 day before the surgery) and at day 7 after the surgery. Univariate and multiple logistic regression analyses were performed to screen risk factors associated with POCD. Receiver operating characteristic (ROC) curve analysis was performed to assess the predictive value of serum 25-hydroxyvitamin D (25(OH)D) expression for POCD.ResultsOf all the 257 enrolled patients, 55 (21.4%) developed POCD within 7 days after the surgery. Serum 25(OH)D level was the only independent risk factor associated with POCD (odds ratio [OR]: 1.77, 95% CI: 1.13-2.78, P = 0.016) by multiple logistic regression analysis. The area under the curve (AUC) of 25(OH)D for POCD was 0.687, with the cut-off value of 11.2ng/mL, sensitivity of 41.82% and specificity of 78.71% respectively (95% CI: 0.617-0.757, P < 0.001).ConclusionsOur results revealed that preoperative serum 25(OH)D level was an independent risk factor for POCD in elderly subjects after TJA.
       
  • 5-(3,3-Dimethyle-1-Triazeno) Imidazole-4-Carboxamide (DTIC) and
           Interleukin-2 Adjuvant Therapy in Resected High-Risk Primary and
           Regionally Metastatic Melanoma
    • Abstract: Publication date: Available online 25 October 2018Source: The American Journal of the Medical SciencesAuthor(s): Amitoj Gill, Rahul Gosain, Hana Gragg, Ryan Bycroft, Shesh N. Rai, Jianmin Pan, Jason A. Chesney, Donald M. MillerBackgroundIn the pre-checkpoint inhibitor era, high-dose interferon (HDI) was the only approved adjuvant therapy for high-risk melanoma. In this manuscript, we analyze the recurrence free survival(RFS), overall survival(OS), and toxicity profile of adjuvant treatment with Interleukin-2(IL-2) and 5-(3,3-Dimethyle-1-Triazeno) Imidazole-4-Carboxamide(DTIC) for resected high-risk melanoma patients.Patients and MethodsAll patients with stage IIB, IIC or stage III melanoma who were treated with DTIC/IL-2 combination therapy at a single institution from 2000 to 2010 were identified from the University of Louisville Hospital medical record. Patients received six months of subcutaneous IL-2 (12 × 106 units days 1 through 4) and intravenous DTIC (750mg/m2 day 1 of each cycle) every 28 days for 6 cycles. Individual medical records were accessed to collect the data.ResultsOf the 112 patients treated, all underwent surgical resection and then received adjuvant treatment. 58.7% of the patients were male, 42.2% female; 99% were Caucasian. 79 (72.5%) of the patients were alive at the time of analysis and 57 (47.7%) patients were currently event free. 69 (63.3%) patients completed all 6 months of adjuvant combination treatment with 13.8% of the patients requiring IL-2 and 21.1% of the patients requiring DTIC dose reduction. Five year OS was 75.57% with RFS of 53.05%.ConclusionsFor several decades, there has not been an ideal adjuvant treatment for patients with resected high risk melanoma. Our retrospective analysis suggests that combination therapy with DTIC/IL-2 is beneficial and relatively well tolerated as an alternative adjuvant treatment for patients with high-risk melanoma.
       
  • Advance Glycation End Products Stimulate Angiotensinogen Production in
           Renal Proximal Tubular Cells
    • Abstract: Publication date: Available online 24 October 2018Source: The American Journal of the Medical SciencesAuthor(s): Joseph M. Garagliano, Akemi Katsurada, Kayoko Miyata, Andrei V. Derbenev, Andrea Zsombok, L. Gabriel Navar, Ryousuke SatouABSTRACTBACKGROUNDElevated advanced glycation end products (AGE) in diabetes mellitus (DM) are implicated in the progression of DM-associated tissue injury, including diabetic nephropathy. The intrarenal renin-angiotensin system, in particular augmentation of angiotensinogen (AGT) in proximal tubular cells (PTC), plays a crucial role in the development of diabetic nephropathy. This study investigated hypothesis that AGE stimulates AGT production in PTC.MATERIALS AND METHODSUrinary AGT and AGE levels in streptozotocin-induced DM mice were measured by enzyme-linked immunosorbent assays. AGT expression and secretion were evaluated in cultured rat PTC receiving 0-200 µg/ml AGE-BSA treatments for 24 hours. Furthermore, intracellular signaling pathways activated by AGE were elucidated.RESULTSDM mice exhibited greater urinary AGT and AGE levels compared to control mice (AGT: 21.6±5.5 ng/day vs. 190.1±57.8 ng/day, AGE: 139.1±21.6 ng/day vs. 332.8±102.7 ng/day). In cultured PTC, treatment with AGE-BSA enhanced AGT mRNA expression (3.43±0.11-fold compared to control), intracellular AGT protein levels (3.60±0.38-fold), and secreted AGT levels (2.11±0.18-fold). On the other hand, AGT levels were not altered in PTC receiving non-glycated BSA. Recombinant soluble AGE receptor, which competes with endogenous AGE receptor, diminished the AGE-induced AGT upregulation, suggesting that AGE-BSA stimulates AGT expression via activation of the AGE receptor. Enhanced phosphorylation of ERK1/2 and c-Jun, but not p38 MAP kinase, were observed in AGE-BSA-treated PTC. AGE-induced AGT augmentation was attenuated by an ERK inhibitor.CONCLUSIONSThe findings indicate that AGE enhances proximal tubular AGT expression via ERK1/2, which can exacerbate the development of diabetic related kidney injury.
       
  • Urinary and plasma cell free DNA comparison for lung cancer patients
           treated with epidermal growth factor receptor - thyroxine kinase
           inhibitors
    • Abstract: Publication date: Available online 23 October 2018Source: The American Journal of the Medical SciencesAuthor(s): Haiying Yu, Mei Liu, Huibing Qiu, Kai Yang BackgroundMutations in the EGFR gene is known to affect treatment efficacy. Comparison of urinary and plasma cell free DNA allow possible non-invasive probing of disease mutationsMethodsA total of 130 patients with known epidermal growth factor receptor (EGFR) mutations derived from tissue biopsies were enrolled. Patients received thyroxine kinase inhibitor (TKI) therapy. Peripheral blood and urine specimens were collected at different time intervals and processed using digital droplet polymerase chain reaction (PCR). Concordance between specimens and the prognostic utility were evaluated with an observational study.ResultsPrior to treatment, we observed an overall agreement of 86.2% between tumor tissue and cell free DNA. Spearman rank correlation coefficient showed a strong correlation between plasma and urinary DNA results. In serial measurements following TKI therapy, secondary EGFR T790M mutation was observed. This occurred in 45% and 30% of non-small cell lung cancer (NSCLC) patients with urine and plasma samples, respectively. Progression free survival of patients with T790M mutation had worse outcome and hazard ratios for the study cohort using urinary and plasma DNA were 5.3 and 3.5 respectively.ConclusionsBoth urinary and plasma DNA presents new opportunities to detect mutations in non-small cell lung cancer (NSCLC) patients and provide real time updates to genetic profiles needed for treatment. In the current study, plasma DNA demonstrated better positive predictive value at baseline. For serial monitoring, we observed that changes in the T790M profiles were detected earlier in urine samples. The prognostic value of the assay can possibly aid in early clinical interventions.
       
  • Slipping Rib Syndrome: Solving the Mystery of the Shooting Pain
    • Abstract: Publication date: Available online 23 October 2018Source: The American Journal of the Medical SciencesAuthor(s): Mohamad Y. Fares, Zakia Dimassi, Hasan Baydoun, Umayya MusharrafiehABSTRACTSlipping Rib Syndrome is an often unrecognized and underdiagnosed condition caused by the increased mobility of the anterior ends of the costal cartilages of the false ribs. Patients usually present with severe intermittent abdominal pain that is exacerbated by various physical movements. Diagnosis of Slipping Rib Syndrome is mainly clinical and can be confirmed by a physical examination technique termed the "Hooking Maneuver." Treatment includes conservative therapy, intercostal nerve block, and surgical operation. Hence, the management and care plan of each patient must be individualized as per the presenting symptoms and medical history. Early recognition and prompt intervention necessitate that physicians be more aware of the symptomatology and prognosis of this condition. This study presents a rare case of a patient with Slipping Rib Syndrome and offers medical insight to the clinical diagnosis and therapeutic modalities of this condition, in light of the current existing literature.
       
  • Hyponatremia Complicating Esophageal Carcinoma: A Challenging Differential
           Diagnosis
    • Abstract: Publication date: Available online 6 June 2018Source: The American Journal of the Medical SciencesAuthor(s): Lina Mackelaite, Eleanor Lederer Hyponatremia is a common complication of cancer and of cancer therapy. Awareness of the many causes of hyponatremia in this setting is critical for ordering the appropriate diagnostic tests, instituting the appropriate treatment, and assessing prognosis of the disorder. This case report highlights the challenges in identifying the cause of hyponatremia in some oncology settings and how misdiagnosis can delay appropriate therapy.
       
  • Shiga Toxin as a Potential Trigger of CFHR1 Deletion-Associated
           Thrombotic Microangiopathy
    • Abstract: Publication date: Available online 5 June 2018Source: The American Journal of the Medical SciencesAuthor(s): Swarna Sri Nalluru, Meera Sridharan, Ronald S. Go, Samar Said, Ariela L. Marshall Thrombotic microangiopathy (TMA) may result from a variety of clinical conditions, including thrombotic thrombocytopenic purpura, Shiga toxin-producing Escherichia coli-associated hemolytic uremic syndrome and complement-mediated hemolytic uremic syndrome. Thrombocytopenic purpura is diagnosed when ADAMTS13 is
       
  • Variation in High-Intensity Statin Use After Hospitalization for Acute
           Vascular Emergencies
    • Abstract: Publication date: Available online 16 May 2018Source: The American Journal of the Medical SciencesAuthor(s): Anusha Shanbhag, Aneesha Ananthula, Raga Deepak Reddy Palagiri, Richa Parikh, Raghunandan Purushothaman, Srikanth Vallurupalli
       
  • IgG4-Related Pleuritis With No Other Organ Involvement
    • Abstract: Publication date: Available online 9 May 2018Source: The American Journal of the Medical SciencesAuthor(s): Toshiyuki Kita, Tomoyuki Araya, Yukari Ichikawa, Nanao Terada, Atsuhiro Kawashima, Satomi Kasashima, Kazuo Kasahara A 65-year-old man was admitted for productive cough and dyspnea. Bilateral pleural effusions were observed on chest X-ray. Although the bilateral pleural effusions were exudative with an increased number of lymphocytes, bacterial culture and polymerase chain reaction analysis for Mycobacterium tuberculosis were negative. Immunological examinations showed high levels of immunoglobulin G4 (IgG4) in both serum and pleural effusion fluid. Pathologic evaluation of a left pleural biopsy specimen using hematoxylin and eosin staining and immunohistochemical staining showed fibrosis-associated lymphoplasmacytic infiltration, 50 IgG4-positive plasma cells per high-power field, and an IgG4/IgG ratio of 40%. Thus, a diagnosis of IgG4-related pleuritis without other systemic manifestations was established. The bilateral pleural effusion improved following corticosteroid therapy. This is a rare case of IgG4-related pleuritis with no other organ involvement.
       
  • Prevalence and Incidence of Immune Thrombocytopenia in Patients With
           Prostate Cancer
    • Abstract: Publication date: Available online 5 May 2018Source: The American Journal of the Medical SciencesAuthor(s): Namratha Vontela, Csaba Kovesdy, Zafar Latif, Robert Lane, Alva Weir
       
  • The Beat Goes On: The Story of 5 Ageless Cardiac Drugs
    • Abstract: Publication date: Available online 25 April 2018Source: The American Journal of the Medical SciencesAuthor(s): Harold Smulyan This article 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.
       
  • Acroosteolysis in Systemic Sclerosis
    • Abstract: Publication date: Available online 18 October 2018Source: The American Journal of the Medical SciencesAuthor(s): Lujayn Akbar, Nuralhuda Akbar, Mona Al Muhaish, Shahrazad Akbar, Atef Kamar
       
  • Empyema secondary to transdiaphragmatic extension of pyogenic liver
           abscess
    • Abstract: Publication date: Available online 16 October 2018Source: The American Journal of the Medical SciencesAuthor(s): Yu-Tse Sheih, Chih-Chiang Wang
       
  • Medical and Scientific Publishing in the 21st Century: A Search
           for Equipoise
    • Abstract: Publication date: Available online 16 October 2018Source: The American Journal of the Medical SciencesAuthor(s): Gailen D. Marshall
       
  • Acute lung injury: Endothelial progenitor cells to the rescue'
    • Abstract: Publication date: Available online 11 October 2018Source: The American Journal of the Medical SciencesAuthor(s): Viranuj Sueblinvong, Daniel J. Weiss
       
  • Pancreatic stellate cells activation and matrix metallopeptidase 2
           expression correlate with lymph node metastasis in pancreas carcinoma
    • Abstract: Publication date: Available online 9 October 2018Source: The American Journal of the Medical SciencesAuthor(s): Yueguang Li, Tao Song, Zhen Chen, Yao Wang, Juyuan Zhang, Ximo Wang BackgroundThis study aimed to investigate the correlation between pancreatic stellate cells activation, matrix metallopeptidase 2 (MMP2) expression and lymph node metastasis in pancreas carcinoma.MethodsAlpha-smooth muscle actin (ACTA2), Desmin (DES) and MMP2 were detected in 40 pancreas carcinoma patients and 10 cases normal pancreas tissues using immunohistochemistry. Then MMP2 and ACTA2 expressions profiles in pancreatic cancer were obtained from UCSC (University of California, Santa Cruz) and SurvExpress.ResultsA total of 67.5% and 55.0% of cases positively expressed ACTA2 and DES in pancreas carcinoma, respectively. MMP2 in pancreas carcinoma was expressed in 55.0% of cases, and there were significant differences between the lymph node metastasis group and the lymph node non-metastasis group, as well as the invasion to peripheral tissue group and the non-invasion to peripheral group (P < 0.01). High throughput sequencing databases verified that ACTA2 and MMP2 gene expression were both up-regulated in pancreatic carcinoma tissues.ConclusionsThe co-expression of ACTA2 and DES was related to the expression of MMP2, and positively correlated with lymph node metastasis. Activation of PSC may promote the expression of MMP2 and enhance the invasion and metastasis of pancreas carcinoma.
       
  • Reversible Blindness as Presenting Manifestation of Severe Diabetic
           Ketoacidosis
    • Abstract: Publication date: Available online 4 October 2018Source: The American Journal of the Medical SciencesAuthor(s): Lee B. Bockus, Zain Ul Abideen Asad, Amna Mohyud Din Chaudhary, Ahmed Awab The presenting symptoms of diabetic ketoacidosis (DKA) include abdominal pain, polyuria and nausea. Diabetes has well known chronic ocular complications like glaucoma, cataracts and retinopathy. We report a case of reversible blindness as a presenting manifestation of DKA that has been reported in literature only three times previously. Our objective is to highlight a rare manifestation of a common disease.A 59-year-old-male presented with painless vision loss for three days and was found to have DKA. The blindness was completely reversed with insulin and bicarbonate treatment. The dramatic presentation and reversibility of blindness was found to be intimately tied with the pH of patient's serum. Our report gives mechanistic insight for this interesting condition.Clinicians should be aware of reversible blindness as a complication of DKA. Timely correction of the severe acidosis and other metabolic disturbances of DKA may be instrumental in preventing permanent vision loss.
       
  • Disseminated tuberculosis in the differential diagnosis of hemophagocytic
           syndrome
    • Abstract: Publication date: Available online 3 October 2018Source: The American Journal of the Medical SciencesAuthor(s): Mohammed Ruzieh, Fadi Safi, Joan Duggan
       
  • Staphylococcus aureus and polymicrobial skin and soft tissue
           infections
    • Abstract: Publication date: Available online 2 October 2018Source: The American Journal of the Medical SciencesAuthor(s): Natalia Malachowa, Frank R. DeLeo
       
  • Primary bone marrow diffuse large B-cell lymphoma presenting as transverse
           myelitis
    • Abstract: Publication date: Available online 2 October 2018Source: The American Journal of the Medical SciencesAuthor(s): Lauren Shea, Yan Zhao, Vishnu Reddy, Talene Yacoubian, Amitkumar Mehta Primary bone marrow diffuse large B-cell lymphoma (BM-DLBCL) is uncommon, with prior reports largely limited to small case series. Here, we report the case of a patient who presented with neurologic deficits consistent with acute transverse myelitis and was found to have DLBCL isolated to the bone marrow. We follow this case with a review of the literature summarizing 107 reported cases of BM-DLBCL. Consistent with our case, literature review indicates that BM-DLBCL is characterized by 1) frequent presentation with cytopenias and B symptoms 2) predominant non-germinal center phenotype and 3) aggressive disease with high International Prognostic Index (IPI) score and low overall survival, with a median survival of 10.0 months in our cohort.
       
  • Glycemic Variability: How to Measure and its Clinical Implication for Type
           2 Diabetes
    • Abstract: Publication date: Available online 2 October 2018Source: The American Journal of the Medical SciencesAuthor(s): Guillermo Umpierrez, Boris P. Kovatchev Glycated hemoglobin A1c (A1C) levels have traditionally been the gold standard for assessing glycemic control and treatment efficacy in patients with type 2 diabetes. However, A1C does not take into account fluctuations in blood glucose levels known as glycemic variability (GV). In recent years, GV has become increasingly clinically relevant because of a better understanding of the need to reach target A1C while avoiding hypoglycemia. GV relates to both hyper- and hypoglycemia, and has been associated with poorer quality of life. Diabetes treatments targeting multiple pathophysiological mechanisms are most beneficial in controlling A1C and reducing GV. In clinical trials, a number of metrics are used to measure GV, many of which are not well understood in the clinical practice. Until a gold standard metric for GV is established, the variety of measurements available may confound the choice of an optimal treatment for an individual patient.
       
  • Errata
    • Abstract: Publication date: Available online 29 September 2018Source: The American Journal of the Medical SciencesAuthor(s):
       
  • THE ARCHETYPES OF MEDICINE A Job Description for the 21st
           Century
    • Abstract: Publication date: Available online 27 September 2018Source: The American Journal of the Medical SciencesAuthor(s): Salvatore Mangione, Jennifer Fisher Wilson, Steven K. HerrineABSTRACTMedicine is facing an identity crisis, one that might find resolution by revisiting a past rich in multifaceted individuals who transcended the strict definition of 'doctor', excelled in other fields of human endeavor, and showed us different ways of being physicians. This paper reviews 12 archetypes that have been part of the profession since its inception, but that, as of late, might have been forgotten. Our goal is to elicit discussion and introspection, with the premise that being a physician ought to be something larger than being a mere technician. If our premise is accepted, then the next step would be to identify those personal traits that made those archetypes possible, so that we can start both recruiting for them and then nurturing them during training.
       
  • A Brief Meta-analysis of Oxygen Therapy for Normoxemic Patients with Acute
           Coronary Syndrome
    • Abstract: Publication date: Available online 25 September 2018Source: The American Journal of the Medical SciencesAuthor(s): Rahman Shah, Sarah M. Wilson, Mallie M. Dennis, Babar Khan, Samuel B. Latham
       
  • Disseminated tuberculosis in the differential diagnosis of hemophagocytic
           syndrome
    • Abstract: Publication date: Available online 20 September 2018Source: The American Journal of the Medical SciencesAuthor(s): Oscar M P Jolobe
       
  • Mega journals, scientifically sound peer review, and medical organizations
    • Abstract: Publication date: Available online 19 September 2018Source: The American Journal of the Medical SciencesAuthor(s): Kenneth Nugent, Hawa Edriss, Somedeb Ball, Bo-Christer Björk
       
  • Metformin Associated with Improved Outcomes in Diabetic Patients with
           Laryngeal and Oropharyngeal Carcinoma
    • Abstract: Publication date: Available online 13 September 2018Source: The American Journal of the Medical SciencesAuthor(s): Amie Ogunsakin, Jordan Infield, Jeffery Zuber, Solomon S. Solomon
       
  • Acute Pancreatitis due to a rare ductal anomaly: ansa pancreatica
    • Abstract: Publication date: Available online 13 September 2018Source: The American Journal of the Medical SciencesAuthor(s): Houssem Harbi, Nozha Toumi, Mohamed Ben Amar
       
  • Clinical Efficacy of Serum-Derived Bovine Immunoglobulin in Patients with
           Refractory Inflammatory Bowel Disease
    • Abstract: Publication date: Available online 5 September 2018Source: The American Journal of the Medical SciencesAuthor(s): Hammad Liaquat, Munish Ashat, Abigail Stocker, Lindsay McElmurray, Karen Beatty, Thomas L. Abell, Gerald Dryden BackgroundInflammatory bowel disease (IBD) can have autoimmunity and/or intestinal barrier dysfunction as part of pathophysiology and may be refractory to all available treatment options. Serum-derived bovine immunoglobulin/protein isolate (SBI) binds microbial components with postulated downstream effects of normalized gut immune and barrier function which may be useful for managing IBD. The purpose of our study was to evaluate the effectiveness of SBI in the management of refractory IBD, particularly symptoms of chronic diarrhea and loose stools.MethodsWe retrospectively analyzed charts for patients diagnosed with IBD (n = 40) who were refractory to standard treatment. Patients received oral SBI 5 gram daily for a period of at least 6 weeks. Twelve patients with IBD fulfilled study inclusion criteria. Each patient graded the severity and frequency of gastrointestinal symptoms before starting SBI and at 6 weeks of treatment using a standardized patient assessment form. Means and standard deviations for all symptom scores at baseline and week 6 of treatment were analyzed.ResultsMean symptom scores decreased significantly for nausea (P = 0.02 for severity and P = 0.03 for mean symptom score) and diarrhea (P = 0.0006, P = 0.0001 and P = 0.0001 for severity, frequency and mean symptom score, respectively).ConclusionTherapy with SBI alleviated some refractory gastrointestinal symptoms in patients with IBD, including nausea and diarrhea. Increased duration, dosage and/or frequency of SBI might provide additional symptom improvement and could be tested through controlled clinical trials with larger sample sizes and longer follow up.
       
  • Current Evidence in Delivery and Therapeutic Uses of Fecal Microbiota
           Transplantation in Human Diseases – Clostridium difficle disease and
           beyond
    • Abstract: Publication date: Available online 5 September 2018Source: The American Journal of the Medical SciencesAuthor(s): Joshua Stripling, Martin Rodriguez
       
  • The Properties of Cytokine in Multiple Sclerosis: Pros and Cons
    • Abstract: Publication date: Available online 5 September 2018Source: The American Journal of the Medical SciencesAuthor(s): Kexin Wang, Feng Song, Alejandro Fernandez-Escobar, Gang Luo, Jun-hui Wang, Yu Sun Multiple sclerosis is a chronic autoimmune disease that affects the central nervous system and is characterized by demyelination, axonal loss, gliosis, and inflammation. The last plays a major role in the onset and propagation of the disease. Multiple sclerosis presents with heterogeneous lesions containing a broad range of cells and soluble mediators of the immune system such as T cells, B cells, macrophages, microglia, cytokines, chemokines, antibodies, complement, and other toxic substances. This review outlines, analyzes, and discusses the different immune mechanisms of MS that are responsible for the initiation and propagation of active lesions, demyelination, axonal injury, remyelination, and cell loss as well as the role of cytokines in the disease process. Pro-inflammatory cytokines such as Interleukin-17 (IL-17), IL-22, tumor necrosis factor-α, IL-1, IL-12, and interferon-γ may cause multiple sclerosis through several signaling pathways. Conversely, anti-inflammatory circulating cytokines such as IL-4 and IL-10 are reduced and theoretically can exert a direct protective effect in this condition. Future studies are necessary to develop effective, safe, and long-lasting strategies to reduce the abnormal cytokine cascades and to treat multiple sclerosis.
       
  • The Birth of Angiotensin: An International Compromise
    • Abstract: Publication date: Available online 4 September 2018Source: The American Journal of the Medical SciencesAuthor(s): Harold Smulyan, Daniel Villarreal Irvine Page in the United States and Eduardo Braun-Menéndez in Argentina led teams of investigators that studied the role of the kidney in blood pressure regulation. Contemporaneously in 1939, each team using different methods discovered and described a new substance now known as angiotensin. At the time of discovery, Page called it “angiotonin” and Braun-Menéndez called it “hipertensina”, anglicized to “hypertensin”. Over time, the importance of this substance in circulatory control, pathophysiology and pharmacology became indisputable and the need for a single name became obvious. In a remarkable accommodation, Page and Braun-Menéndez agreed to forego any claim to priority and chose a name with elements of both. Following this compromise, Page and Braun-Menéndez went on to become leaders in science in their own countries as well as recognition world-wide while angiotensin and its derivatives have become standard components in the understanding and treatment of diseases of the heart, kidney and brain.
       
  • Lupus and Cardiovascular Disease
    • Abstract: Publication date: Available online 31 August 2018Source: The American Journal of the Medical SciencesAuthor(s): Jan Nilsson
       
  • The use of microbiome restoration therapeutics to eliminate intestinal
           colonization with multidrug-resistant organisms
    • Abstract: Publication date: Available online 29 August 2018Source: The American Journal of the Medical SciencesAuthor(s): Srinivasa Nithin Gopalsamy, Michael H. Woodworth, Tiffany Wang, Cynthia T. Carpentieri, Nirja Mehta, Rachel J. Friedman-Moraco, Aneesh K. Mehta, Christian P. Larsen, Colleen S. Kraft Antibiotic resistance (AR) has been described by the World Health Organization as an increasingly serious threat to global public health. Many mechanisms of AR have become widespread due to global selective pressures such as widespread antibiotic use. The intestinal tract is an important reservoir for many multidrug-resistant organisms (MDROs) and next-generation sequencing has expanded understanding of the resistome, defined as the comprehensive sum of genetic determinants of AR. Intestinal decolonization has been explored as a strategy to eradicate MDROs with selective digestive tract decontamination and probiotics being notable examples with mixed results. This review focuses on fecal microbiota transplantation (FMT) and the early evidence supporting its efficacy in decolonizing MDROs and potential mechanisms of action to reduce AR genes. Current evidence suggests FMT may have promise in restoring healthy microbial diversity and reducing AR, and clinical trials are underway to better characterize its safety and efficacy.
       
  • Correlations of microRNA-21 Gene Polymorphisms with Chemosensitivity and
           Prognosis of Cervical Cancer
    • Abstract: Publication date: Available online 29 August 2018Source: The American Journal of the Medical SciencesAuthor(s): Jing Zhang, Yan-Hua Li, Hong-Li Liu, Yuan Zhang, Qing-Song Zhang, Sheng-Ze Li BackgroundWe investigated correlations of miR-21 gene polymorphisms including rs1292037 (A> G) and rs13137 (A> T) with the chemosensitivity to cisplatin plus paclitaxel, and prognosis before cervical cancer (CC) surgery, which may provide a novel target for prevention and treatment of CC.MethodsA total of 165 patients with CC were divided into 2 groups, a sensitive group and resistance group. Gene polymorphisms of rs1292037 (A> G) and rs13137 (A> T) were detected respectively. Logistic and Cox multivariate regression analyses were used to explore factors that influence resistance to cisplatin plus paclitaxel.Resultsrs1292037 (A> G) locus AG, GG, AG + GG and G allele in miR-21 gene may increase chemoresistance to cisplatin plus paclitaxel in CC. The risk factors of prognosis included rs1292037 (A> G) locus, tumor stage, maximum lesion diameter and LNM (hazard ratio [HR] = 1.819, 95% CI = 1.127-2.935; HR = 1.504, 95% CI = 1.070-2.114; HR = 1.671, 95% CI = 1.038-2.689; HR = 3.043, 95% CI = 1.783-5.193). The influencing factors of resistance to cisplatin plus paclitaxel included maximum lesion diameter, tumor stage, lymph node metastasis (LNM) and rs1292037 (odds ratio [OR] = 14.047, 95% CI = 5.694-34.653; OR = 5.873, 95% CI = 3.104-11.110; OR = 3.574, 95% CI = 1.554-8.216; OR = 2.449, 95% CI = 1.052-5.705).Conclusionrs1292037 (A> G) locus are associated with the chemoresistance to cisplatin plus paclitaxel and prognosis of patients with CC. In addition to that, the G allele at rs1292037 (A> G) locus increases the risk of preoperative chemoresistance to cisplatin plus paclitaxel and is a poor prognostic factor for patients with CC.
       
  • IgG4-related pleuritis without tuberculous pleurisy
    • Abstract: Publication date: Available online 28 August 2018Source: The American Journal of the Medical SciencesAuthor(s): Toshiyuki Kita
       
  • We Care About Patient-Reported Outcomes, But We Don't Communicate with our
           Patients
    • Abstract: Publication date: Available online 27 August 2018Source: The American Journal of the Medical SciencesAuthor(s): Devika Nair
       
  • Ewing's sarcoma/peripheral primitive neuroectodermal tumors in bronchus
    • Abstract: Publication date: Available online 22 August 2018Source: The American Journal of the Medical SciencesAuthor(s): Jun Chen, Tao Yuan, Xiao Liu, Bei Hua, Chenfeng Dong, Yawu Liu, Guanmin Quan Ewing sarcoma/peripheral primitive neuroectodermal tumors (ES/pPNET), a member of the Ewing sarcoma family of tumors, is a malignant soft tissue tumor with small undifferentiated neuroectodermal cells. Primary trachea-bronchial ES/pPNET is very rare. The most common pulmonary ES is due to a metastasis. We describe a case of ES/pPNET which originated in the left basal trunk bronchus. The patient was a 30-year-old male, presenting with irritable cough and fever for 10 days. A tumor of 60 mm in diameter was found in the left basal trunk bronchus, extending to the left lower lobe. No distant metastases were detected. Histopathological examination revealed a malignancy of ES/pPNET with a diffuse proliferation of round cells, a Flexner-Wintersteiner rosette formation and positive staining for CD99. The patient was successfully treated with a combination of left lower lobectomy and adjuvant chemotherapy and has remained disease-free for approximately 18 months at follow-up. This case highlights that ES/pPNET should be considered as a differential diagnosis in cases of trachea-bronchial tumors.
       
  • Study of The Microbiome has Reached Prime Time
    • Abstract: Publication date: Available online 22 August 2018Source: The American Journal of the Medical SciencesAuthor(s): C. Mel Wilcox
       
  • A patient-centered approach to care in chronic disease
    • Abstract: Publication date: Available online 21 August 2018Source: The American Journal of the Medical SciencesAuthor(s): Jeffrey J. Swigris
       
  • DEVELOPMENT OF THE PEDIATRIC GUT MICROBIOME: IMPACT ON HEALTH AND DISEASE
    • Abstract: Publication date: Available online 21 August 2018Source: The American Journal of the Medical SciencesAuthor(s): Faith D. Ihekweazu, James VersalovicABSTRACTThe intestinal microbiota are important in proper human growth and development before and after birth, during infancy and childhood. Microbial composition may yield insights into the temporal development of microbial communities and vulnerabilities to disorders of microbial ecology such as recurrent Clostridium difficile infection. Discoveries of key microbiome features of carbohydrate and amino acid metabolism are lending new insights into possible new therapies or preventative strategies for inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS). In this review, we summarize the current understanding of the development of the pediatric gastrointestinal microbiome, the influence of the microbiome on the developing brain through the gut-brain axis, and the impact of dysbiosis on the development of disease. Microbial dysbiosis will be explored in the context of pediatric allergy and asthma, recurrent C. difficile infection, IBD, IBS, and metabolic disorders. The central premise is that the human intestinal microbiome plays a vital role throughout human life beginning in the prenatal period and extending throughout childhood in health and disease.
       
  • Broadening the differential diagnosis of IgG4-related pleuritis
    • Abstract: Publication date: Available online 6 August 2018Source: The American Journal of the Medical SciencesAuthor(s): Oscar M.P. Jolobe
       
  • Honiton laces in oral cavity
    • Abstract: Publication date: Available online 1 August 2018Source: The American Journal of the Medical SciencesAuthor(s): Shelly Arora, Ranjeet Ajit Bapat, Tanay Chaubal
       
  • Mitigation of stroke risk in nonvalvular atrial fibrillation patients with
           high grade carotid artery stenosis
    • Abstract: Publication date: Available online 1 August 2018Source: The American Journal of the Medical SciencesAuthor(s): Oscar M P Jolobe
       
  • Risk Factors for Low Pharmacy Refill Adherence among Older Hypertensive
           Men and Women by Race
    • Abstract: Publication date: Available online 29 July 2018Source: The American Journal of the Medical SciencesAuthor(s): LaKeisha G. Williams, Erin Peacock, Cara Joyce, Lydia A. Bazzano, Daniel Sarpong, Paul K. Whelton, Elizabeth W. Holt, Richard Re, Edward Frohlich, Jiang He, Paul Muntner, Marie Krousel-Wood BackgroundSex-race stratification may lead to identification of risk factors for low antihypertensive medication adherence that are not apparent when assessing risk factors in women and men without race stratification. We examined risk factors associated with low pharmacy refill adherence across sex-race subgroups (white women, black women, white men, black men) within the Cohort Study of Medication Adherence among Older Adults (n=2,122).MethodsPharmacy refill adherence was calculated as proportion of days covered (PDC) using all antihypertensive prescriptions filled in the year prior to a baseline risk factor survey. Sex- and sex-race-stratified multivariable Poisson regression models with robust standard errors were used to estimate adjusted prevalence ratios and 95% confidence intervals for associations between participant characteristics and low adherence.ResultsPrevalence of low adherence was 22.9% versus 40.7% in white versus black women (p
       
  • Emerging role for exosomes in the progress of stem cell research
    • Abstract: Publication date: Available online 19 July 2018Source: The American Journal of the Medical SciencesAuthor(s): Yuan Kai-Ming, Zhang Pei-Hua, Qi Shan-Shan, Zhu Qiao-Zhen, Li Ping Exosomes are small secretory vesicles that are involved in intercellular communication. Exosomes are secreted by many types of cells and exert important functions in plasma-membrane exchange as well as the transport of bioactive substances, such as proteins, messenger ribonucleic acids (mRNAs), micro ribonucleic acids (miRNAs) and organelles. Exosomes may regulate physiological processes by altering gene regulatory networks or epigenetic recombination. Recent studies have shown that exosomes secreted by stem cells can effectively transport proteins, mRNAs and miRNAs and play important roles in the regulation of tissue regeneration. This report reviews current progress in exosome studies as well as their emerging roles in stem cell research and potential clinical use.
       
  • Hemophagocytic lymphohistiocytosis in the elderly
    • Abstract: Publication date: Available online 17 July 2018Source: The American Journal of the Medical SciencesAuthor(s): Reyna Altook, Mohammed Ruzieh, Avneet Singh, Wael Alamoudi, Zeinab Moussa, Hussam Alim, Fadi Safi, Joan Duggan Hemophagocytic lymphohistiocytosis (HLH) is a rare disease of massive, dysregulated cytokine release and secondary multi-organ failure, and is associated with high mortality. Primary HLH occurs predominately in infants and young children with a genetic predisposition. Acquired HLH is less well characterized and usually occurs in younger adults in the setting of severe inflammation triggered by infection or malignancy. Little is known about the disease in elderly. We report 3 patients>50 years old who presented with multi-organ failure and shock without an identifiable source and were ultimately diagnosed with acquired HLH. We performed a literature review of HLH in adults>50 years of age and identified an additional 68 cases. Mean age was 62 years, with male predominance. Most cases were triggered by infection (49%) followed by malignancy (27%). Nineteen patients were treated with the HLH-94 protocol, 11 received corticosteroids and the remainder received non-HLH specific interventions. Overall mortality was 62%.
       
  • A case of Takayasu Arteritis with the ostium of left main coronary artery
           obstructed by prolapsed thickened ascending aortic intima
    • Abstract: Publication date: Available online 7 July 2018Source: The American Journal of the Medical SciencesAuthor(s): Jiayue Feng, Sen He, Hua Wang
       
  • Walter Reed at Camp Lazear: A Paradigm for Contemporary Clinical Research
    • Abstract: Publication date: Available online 5 July 2018Source: The American Journal of the Medical SciencesAuthor(s): David Ploth Throughout the time of the early settlement and development of North America there were frequent epidemics of Yellow Fever. Yellow fever was particularly threatening because it was associated with an extremely high mortality rate; up to 85% of those infected died of the disease. Yellow Fever in the Western world is likely an additional, horrific by-product of early slavery in North America. It is thought that ships transporting captured Africans likely conveyed both the major vector, the Aedes aegypti mosquito, and the RNA Yellow Fever virus from Africa to North America. Infected ships landing in port cities resulted in epidemics that proved impossible to control with conventional interventions. Walter Reed and the U.S. Army Commission solved the mystery of the mode of Yellow Fever transmission. Notably, Reed and his co-workers not only proved the mosquito the vector of transmission but did so by constructing focused research questions leading to cleverly devised experiments that resulted in definitive answers. The results of their research not only proved that the mosquito transmitted the disease, but disproved the other proposed modes of transmission. In nearly all respects Reed's experiments are an excellent paradigm for addressing clinical research questions today.
       
  • Folliculotropic mycosis fungoides with CD30+ large-cell transformation
    • Abstract: Publication date: Available online 23 June 2018Source: The American Journal of the Medical SciencesAuthor(s): Lei Yao, Yan Yu, Yu Guo, Shan-shan Li
       
  • Complete Heart Block in Acute Aortic Dissection: An Unusual Presentation
    • Abstract: Publication date: Available online 21 June 2018Source: The American Journal of the Medical SciencesAuthor(s): Kiran Kumar Gudivada, Ashish Kumar Umesh, Akarsh Reddy Budibetta Sudeendrababu
       
  • Effect of trimetazidine on preventing contrast-induced acute kidney injury
           in patients with diabetes
    • Abstract: Publication date: Available online 18 June 2018Source: The American Journal of the Medical SciencesAuthor(s): Weidai Zhang, Kefei Wu, Hanfei Lin, Jiawei Zhang, Songming Chen
       
  • "This is a Christian institution and we will tolerate no Jews here": The
           Brooklyn Medical Interns Hazings
    • Abstract: Publication date: Available online 18 June 2018Source: The American Journal of the Medical SciencesAuthor(s): Edward C. Halperin Anti-Semitic quotas to restrict access to medical school, graduate medical education, and hospital privileges were common in the US from the 1920’s to the 1960’s. In Brooklyn, New York, medical education prejudice resulted in violence. In 1916 a Jewish intern at Kings County Hospital (KCH), Matthew Olstein, was bound and gagged by Christian interns, put on a train at Grand Central Station, and warned that if he returned he would be thrown in the East River. Olstein died in combat in World War I as an Army physician. In 1927 three Jewish interns at KCH were assaulted, bound, dumped in tubs of water, and covered in black fluid. Six gentile physicians were charged with assault. Criminal proceedings and public investigations followed. These attacks are the only known episodes of violence associated with American medical education anti-Semitism.
       
  • Sudden Cardiac Arrest in a Young Patient with Severe Pectus
           Excavatum,
    • Abstract: Publication date: Available online 9 June 2018Source: The American Journal of the Medical SciencesAuthor(s): Rayan Jo Rachwan, Andrea K. Purpura, Basil M. Kahwash We report a case of sudden cardiac arrest in the setting of ventricular fibrillation in a previously healthy 19-year-old male. Chest imaging demonstrated severe pectus excavatum with Pectus Severity Index of 22.7. Extensive workup was unrevealing for other cardiopulmonary etiologies, including conduction and structural abnormalities. The patient was scheduled for a Ravitch procedure and was discharged on a wearable defibrillator vest for temporary protection against ventricular arrhythmias. Later, the patient underwent subcutaneous implantable cardioverter defibrillator placement. Sudden cardiac arrest as an initial presentation of pectus excavatum is a rare entity scarcely discussed in medical literature. In this patient-centered focused review, we explore this unique case and offer our management approach amid the lack of concrete guidelines.
       
 
 
JournalTOCs
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
Email: journaltocs@hw.ac.uk
Tel: +00 44 (0)131 4513762
Fax: +00 44 (0)131 4513327
 
Home (Search)
Subjects A-Z
Publishers A-Z
Customise
APIs
Your IP address: 54.159.44.54
 
About JournalTOCs
API
Help
News (blog, publications)
JournalTOCs on Twitter   JournalTOCs on Facebook

JournalTOCs © 2009-