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Publisher: Elsevier   (Total: 3031 journals)

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Showing 1 - 200 of 3031 Journals sorted alphabetically
AASRI Procedia     Open Access   (Followers: 15)
Academic Pediatrics     Hybrid Journal   (Followers: 20, SJR: 1.402, h-index: 51)
Academic Radiology     Hybrid Journal   (Followers: 16, SJR: 1.008, h-index: 75)
Accident Analysis & Prevention     Partially Free   (Followers: 79, SJR: 1.109, h-index: 94)
Accounting Forum     Hybrid Journal   (Followers: 22, SJR: 0.612, h-index: 27)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 27, SJR: 2.515, h-index: 90)
Achievements in the Life Sciences     Open Access   (Followers: 4)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 5, SJR: 0.338, h-index: 19)
Acta Astronautica     Hybrid Journal   (Followers: 302, SJR: 0.726, h-index: 43)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 3)
Acta Biomaterialia     Hybrid Journal   (Followers: 25, SJR: 2.02, h-index: 104)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription  
Acta de Investigación Psicológica     Open Access   (Followers: 2)
Acta Ecologica Sinica     Open Access   (Followers: 8, SJR: 0.172, h-index: 29)
Acta Haematologica Polonica     Free   (SJR: 0.123, h-index: 8)
Acta Histochemica     Hybrid Journal   (Followers: 3, SJR: 0.604, h-index: 38)
Acta Materialia     Hybrid Journal   (Followers: 195, 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: 9, SJR: 0.915, h-index: 53)
Acta Otorrinolaringologica (English Edition)     Full-text available via subscription   (Followers: 1)
Acta Otorrinolaringológica Española     Full-text available via subscription   (Followers: 3, SJR: 0.311, h-index: 16)
Acta Pharmaceutica Sinica B     Open Access   (Followers: 2)
Acta Poética     Open Access   (Followers: 4)
Acta Psychologica     Hybrid Journal   (Followers: 21, SJR: 1.365, h-index: 73)
Acta Sociológica     Open Access  
Acta Tropica     Hybrid Journal   (Followers: 5, SJR: 1.059, h-index: 77)
Acta Urológica Portuguesa     Open Access  
Actas Dermo-Sifiliograficas     Full-text available via subscription   (Followers: 4)
Actas Dermo-Sifiliográficas (English Edition)     Full-text available via subscription   (Followers: 3)
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: 2)
Actualites Pharmaceutiques     Full-text available via subscription   (Followers: 5, SJR: 0.141, h-index: 3)
Actualites Pharmaceutiques Hospitalieres     Full-text available via subscription   (Followers: 4, SJR: 0.112, h-index: 2)
Acupuncture and Related Therapies     Hybrid Journal   (Followers: 4)
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: 5)
Additive Manufacturing     Hybrid Journal   (Followers: 7, SJR: 1.039, h-index: 5)
Additives for Polymers     Full-text available via subscription   (Followers: 20)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 119, 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: 15, SJR: 2.071, h-index: 82)
Advances in Anesthesia     Full-text available via subscription   (Followers: 24, SJR: 0.169, h-index: 4)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 3)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 6, 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: 21, SJR: 1.286, h-index: 49)
Advances In Atomic, Molecular, and Optical Physics     Full-text available via subscription   (Followers: 16, 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: 3, SJR: 0.619, h-index: 48)
Advances in Cancer Research     Full-text available via subscription   (Followers: 26, SJR: 2.215, h-index: 78)
Advances in Carbohydrate Chemistry and Biochemistry     Full-text available via subscription   (Followers: 9, SJR: 0.9, h-index: 30)
Advances in Catalysis     Full-text available via subscription   (Followers: 5, SJR: 2.139, h-index: 42)
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: 24, 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: 8, 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: 18, SJR: 2.314, h-index: 130)
Advances in Computers     Full-text available via subscription   (Followers: 16, SJR: 0.223, h-index: 22)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 11)
Advances in Digestive Medicine     Open Access   (Followers: 4)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 5)
Advances in Drug Research     Full-text available via subscription   (Followers: 22)
Advances in Ecological Research     Full-text available via subscription   (Followers: 39, SJR: 3.25, h-index: 43)
Advances in Engineering Software     Hybrid Journal   (Followers: 25, 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: 38, SJR: 5.465, h-index: 64)
Advances in Exploration Geophysics     Full-text available via subscription   (Followers: 3)
Advances in Fluorine Science     Full-text available via subscription   (Followers: 8)
Advances in Food and Nutrition Research     Full-text available via subscription   (Followers: 41, SJR: 0.674, h-index: 38)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 14)
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: 11)
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: 18, SJR: 0.906, h-index: 24)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 8, 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: 33, SJR: 4.152, h-index: 85)
Advances in Inorganic Chemistry     Full-text available via subscription   (Followers: 9, SJR: 1.132, h-index: 42)
Advances in Insect Physiology     Full-text available via subscription   (Followers: 3, SJR: 1.274, h-index: 27)
Advances in Integrative Medicine     Hybrid Journal   (Followers: 4)
Advances in Intl. Accounting     Full-text available via subscription   (Followers: 4)
Advances in Life Course Research     Hybrid Journal   (Followers: 7, 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: 8)
Advances in Marine Biology     Full-text available via subscription   (Followers: 16, SJR: 1.645, h-index: 45)
Advances in Mathematics     Full-text available via subscription   (Followers: 10, SJR: 3.261, h-index: 65)
Advances in Medical Sciences     Hybrid Journal   (Followers: 5, 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: 10)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 6, 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: 3)
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: 7, SJR: 0.148, h-index: 11)
Advances in Parasitology     Full-text available via subscription   (Followers: 7, SJR: 2.37, h-index: 73)
Advances in Pediatrics     Full-text available via subscription   (Followers: 20, SJR: 0.4, h-index: 28)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 14)
Advances in Pharmacology     Full-text available via subscription   (Followers: 13, SJR: 1.718, h-index: 58)
Advances in Physical Organic Chemistry     Full-text available via subscription   (Followers: 7, 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: 8)
Advances in Plant Pathology     Full-text available via subscription   (Followers: 5)
Advances in Porous Media     Full-text available via subscription   (Followers: 4)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 18)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 17, SJR: 1.5, h-index: 62)
Advances in Psychology     Full-text available via subscription   (Followers: 56)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 5, SJR: 0.478, h-index: 32)
Advances in Radiation Oncology     Open Access  
Advances in Small Animal Medicine and Surgery     Hybrid Journal   (Followers: 1, SJR: 0.1, h-index: 2)
Advances in Space Research     Full-text available via subscription   (Followers: 332, SJR: 0.606, h-index: 65)
Advances in Structural Biology     Full-text available via subscription   (Followers: 7)
Advances in Surgery     Full-text available via subscription   (Followers: 6, SJR: 0.823, h-index: 27)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 28, SJR: 1.321, h-index: 56)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 14)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 12)
Advances in Virus Research     Full-text available via subscription   (Followers: 5, SJR: 1.878, h-index: 68)
Advances in Water Resources     Hybrid Journal   (Followers: 42, SJR: 2.408, h-index: 94)
Aeolian Research     Hybrid Journal   (Followers: 5, SJR: 0.973, h-index: 22)
Aerospace Science and Technology     Hybrid Journal   (Followers: 303, 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: 4, SJR: 0.344, h-index: 6)
Ageing Research Reviews     Hybrid Journal   (Followers: 7, SJR: 3.289, h-index: 78)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 389, 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: 29, SJR: 1.275, h-index: 74)
Agricultural Water Management     Hybrid Journal   (Followers: 36, SJR: 1.546, h-index: 79)
Agriculture and Agricultural Science Procedia     Open Access  
Agriculture and Natural Resources     Open Access   (Followers: 1)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 48, 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: 3, 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: 9, SJR: 0.922, h-index: 66)
Alcoholism and Drug Addiction     Open Access   (Followers: 5)
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  
Algal Research     Partially Free   (Followers: 7, SJR: 2.05, h-index: 20)
Alkaloids: Chemical and Biological Perspectives     Full-text available via subscription   (Followers: 3)
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)
ALTER - European J. of Disability Research / Revue Européenne de Recherche sur le Handicap     Full-text available via subscription   (Followers: 6, SJR: 0.158, h-index: 9)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 45, SJR: 4.289, h-index: 64)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 5)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 3)
American Heart J.     Hybrid Journal   (Followers: 45, SJR: 3.157, h-index: 153)
American J. of Cardiology     Hybrid Journal   (Followers: 47, SJR: 2.063, h-index: 186)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 34, SJR: 0.574, h-index: 65)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 6, 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: 32, SJR: 8.769, h-index: 256)
American J. of Infection Control     Hybrid Journal   (Followers: 25, SJR: 1.259, h-index: 81)
American J. of Kidney Diseases     Hybrid Journal   (Followers: 31, SJR: 2.313, h-index: 172)
American J. of Medicine     Hybrid Journal   (Followers: 48, 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: 173, SJR: 2.255, h-index: 171)
American J. of Ophthalmology     Hybrid Journal   (Followers: 51, SJR: 2.803, h-index: 148)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 2)
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: 22, SJR: 0.59, h-index: 45)
American J. of Pathology     Hybrid Journal   (Followers: 23, SJR: 2.653, h-index: 228)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 21, SJR: 2.764, h-index: 154)
American J. of Surgery     Hybrid Journal   (Followers: 32, SJR: 1.286, h-index: 125)
American J. of the Medical Sciences     Hybrid Journal   (Followers: 13, SJR: 0.653, h-index: 70)
Ampersand : An Intl. J. of General and Applied Linguistics     Open Access   (Followers: 5)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.066, h-index: 51)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 52, SJR: 0.124, h-index: 9)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 3)
Anales de Cirugia Vascular     Full-text available via subscription  
Anales de Pediatría     Full-text available via subscription   (Followers: 2, 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: 2, SJR: 2.577, h-index: 7)
Analytica Chimica Acta     Hybrid Journal   (Followers: 38, SJR: 1.548, h-index: 152)
Analytical Biochemistry     Hybrid Journal   (Followers: 152, SJR: 0.725, h-index: 154)
Analytical Chemistry Research     Open Access   (Followers: 7, SJR: 0.18, h-index: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 10)
Anesthésie & Réanimation     Full-text available via subscription  
Anesthesiology Clinics     Full-text available via subscription   (Followers: 21, SJR: 0.421, h-index: 40)
Angiología     Full-text available via subscription   (SJR: 0.124, h-index: 9)
Angiologia e Cirurgia Vascular     Open Access  
Animal Behaviour     Hybrid Journal   (Followers: 141, SJR: 1.907, h-index: 126)
Animal Feed Science and Technology     Hybrid Journal   (Followers: 5, SJR: 1.151, h-index: 83)
Animal Reproduction Science     Hybrid Journal   (Followers: 5, SJR: 0.711, h-index: 78)
Annales d'Endocrinologie     Full-text available via subscription   (SJR: 0.394, h-index: 30)
Annales d'Urologie     Full-text available via subscription  
Annales de Cardiologie et d'Angéiologie     Full-text available via subscription   (SJR: 0.177, h-index: 13)
Annales de Chirurgie de la Main et du Membre Supérieur     Full-text available via subscription  
Annales de Chirurgie Plastique Esthétique     Full-text available via subscription   (Followers: 2, SJR: 0.354, h-index: 22)
Annales de Chirurgie Vasculaire     Full-text available via subscription   (Followers: 1)

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Journal Cover American Journal of the Medical Sciences
  [SJR: 0.653]   [H-I: 70]   [13 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 0002-9629
   Published by Elsevier Homepage  [3031 journals]
  • Fulminant Serratia marcescens Panophthalmitis
    • Authors: Hsiao-Pei Guo; Tsung-Jen Wang
      Abstract: Publication date: April 2017
      Source:The American Journal of the Medical Sciences, Volume 353, Issue 4
      Author(s): Hsiao-Pei Guo, Tsung-Jen Wang


      PubDate: 2017-03-24T00:03:20Z
      DOI: 10.1016/j.amjms.2016.09.005
       
  • MiR-1, a Potential Predictive Biomarker for Recurrence in Prostate Cancer
           After Radical Prostatectomy
    • Authors: Wei Wei; Jiangyong Leng; Hongxiang Shao; Weidong Wang
      Pages: 315 - 319
      Abstract: Publication date: April 2017
      Source:The American Journal of the Medical Sciences, Volume 353, Issue 4
      Author(s): Wei Wei, Jiangyong Leng, Hongxiang Shao, Weidong Wang
      Background Increasing evidence suggests that aberrant microRNAs expressions are significantly associated with cancer progression. Previous studies have reported that the relative expression of miR-1 is significantly downregulated in recurrent prostate cancer (PCa) samples when compared with nonrecurrent PCa tissues. However, whether miR-1 can serve as a novel predictive biomarker for PCa recurrence still remains unclear. Materials and Methods The patients with clinically localized PCa who underwent radical prostatectomy by the same medical team at the Department of Urology, Ningbo No.2 Hospital were enrolled in this study. We examined the miR-1 expression levels in recurrent and nonrecurrent tumor samples by quantitative reverse transcription polymerase chain reaction. Univariate and multivariate Cox proportional hazards analyses were used for the evaluation of potential predictors of PCa recurrence. Results During the study period, 78 patients (including 27 in the recurrent group and 51 in the nonrecurrent group) who were diagnosed with PCa and who underwent radical prostatectomy were included in the final analysis. MiR-1 was significantly downregulated in recurrent PCa tissues when compared with nonrecurrent tumor samples (P < 0.001). The univariate and multivariate Cox proportional hazards analyses indicated that miR-1 was the only independent prognostic factor for PCa recurrence (hazard ratio = 1.86; 95% CI: 1.21-2.94; P = 0.011). The area under the curve value of miR-1 for PCa recurrence was 0.885 (P < 0.001) with the sensitivity of 0.863 and specificity of 0.889 based on receiver operating characteristic curve analysis. Conclusions This study identifies that miR-1 in PCa tissues can function as an important independent predictive factor for PCa recurrence.

      PubDate: 2017-03-24T00:03:20Z
      DOI: 10.1016/j.amjms.2017.01.006
       
  • Membranoproliferative Glomerulonephritis in Pregnancy
    • Authors: Devika Nair; Laura Kidd; N. Kevin Krane
      Pages: 320 - 328
      Abstract: Publication date: April 2017
      Source:The American Journal of the Medical Sciences, Volume 353, Issue 4
      Author(s): Devika Nair, Laura Kidd, N. Kevin Krane
      Background Membranoproliferative glomerulonephritis (MPGN) is an uncommon form of glomerulonephritis and it can be particularly difficult to predict outcomes and manage women with this disorder during pregnancy. Materials and Methods The management of 3 successful pregnancies in women with MPGN from 1 center and previously described cases from the world literature are reviewed. This includes a number of large studies of pregnancy in women with underlying glomerular disease as well as small case series and individual reports. Courses of these pregnancies, maternal and fetal outcomes, and management, when described, were included in this review. Results Some successful outcomes used antiplatelet therapy and plasmapheresis, but high-dose intravenous, followed by oral, corticosteroid therapy was used most frequently in patients with successful outcomes. Conclusions The data provided is meant as a guide for clinicians who provide care for women with MPGN who are considering pregnancy or women who present with this disorder while pregnant.

      PubDate: 2017-03-24T00:03:20Z
      DOI: 10.1016/j.amjms.2017.01.007
       
  • Lupus Hepatitis and Autoimmune Hepatitis (Lupoid Hepatitis)
    • Authors: Avinash Adiga; Kenneth Nugent
      Pages: 329 - 335
      Abstract: Publication date: April 2017
      Source:The American Journal of the Medical Sciences, Volume 353, Issue 4
      Author(s): Avinash Adiga, Kenneth Nugent
      Liver dysfunction occurs in approximately 50% of patients with systemic lupus erythematosus (SLE), and patients with SLE and elevated liver enzymes can present a complicated and difficult differential diagnosis. Lupus hepatitis and autoimmune hepatitis are 2 immunologic conditions involving the liver, which can have similar clinical, laboratory and systemic presentations, leading to difficulties in diagnosis. Physicians need to be aware of these 2 hepatic diseases as diagnosis and appropriate therapy need to occur early in the disease course to prevent progression to advanced liver disease. We review the liver diseases associated with SLE and discuss the approach to the diagnostic evaluation of these patients. In particular, differentiation between lupus hepatitis and autoimmune hepatitis requires careful clinical and often histologic evaluation.

      PubDate: 2017-03-24T00:03:20Z
      DOI: 10.1016/j.amjms.2016.10.014
       
  • Uric Acid Excretion Predicts Increased Blood Pressure Among American
           Adolescents of African Descent
    • Authors: Sylvie Mrug; Michal Mrug; Anjana Madan Morris; Nina Reynolds; Anita Patel; Danielle C. Hill; Daniel I. Feig
      Pages: 336 - 341
      Abstract: Publication date: April 2017
      Source:The American Journal of the Medical Sciences, Volume 353, Issue 4
      Author(s): Sylvie Mrug, Michal Mrug, Anjana Madan Morris, Nina Reynolds, Anita Patel, Danielle C. Hill, Daniel I. Feig
      Background Hyperuricemia predicts the incidence of hypertension in adults and its treatment has blood pressure (BP)-lowering effects in adolescents. To date, no studies have examined the predictive usage of hyperuricemia or urinary uric acid excretion on BP changes in adolescents. Mechanistic models suggest that uric acid impairs both endothelial function and vascular compliance, which would potentially exacerbate a myriad of hypertensive mechanisms, yet little is known about interaction of uric acid and other hypertension risk factors. Materials and Methods The primary study was aimed at the effects of stress on BP in adolescents. A community sample of 84 low-income, urban adolescents (50% male, 95% African American, mean age = 13.36 ± 1 years) was recruited from public schools. Youth completed a 12-hour (overnight) urine collection at home and their BP was measured during rest and in response to acute psychosocial stress. Seventy-six of the adolescents participated in a follow-up visit at 1.5 years when their resting BP was reassessed. In this substudy, we assessed the relationship of renal urate excretion and BP reactivity. Results After adjusting for resting BP levels at baseline and other covariates, higher levels of uric acid excretion predicted greater BP reactivity to acute psychosocial stress and higher resting BP at 18 months. Conclusions Urinary excretion of uric acid can serve as an alternative, noninvasive measure of serum uric acid levels that are predictive of BP changes. As hyperuricemia-associated hypertension is treatable, urban adolescents may benefit from routine screening for hyperuricemia or high uric acid excretion.

      PubDate: 2017-03-24T00:03:20Z
      DOI: 10.1016/j.amjms.2017.01.008
       
  • Aortic Dissection in Takayasu Arteritis
    • Authors: Kun-Qi Yang; Yan-Kun Yang; Xu Meng; Ying Zhang; Hui-Min Zhang; Hai-Ying Wu; Ya-Xin Liu; Xiong-Jing Jiang; Jun Cai; Xian-Liang Zhou; Ru-Tai Hui; De-Yu Zheng; Li-Sheng Liu
      Pages: 342 - 352
      Abstract: Publication date: April 2017
      Source:The American Journal of the Medical Sciences, Volume 353, Issue 4
      Author(s): Kun-Qi Yang, Yan-Kun Yang, Xu Meng, Ying Zhang, Hui-Min Zhang, Hai-Ying Wu, Ya-Xin Liu, Xiong-Jing Jiang, Jun Cai, Xian-Liang Zhou, Ru-Tai Hui, De-Yu Zheng, Li-Sheng Liu
      Background Aortic dissection (AD) is a rare complication of Takayasu arteritis (TA). The clinical presentation and long-term management outcomes of AD in patients with TA have not been well described. Materials and Methods We conducted a retrospective study of patients with TA along with AD admitted to Fuwai Hospital between January 1985 and March 2016. Clinical data and follow-up data were collected and analyzed. Results Of the 1,154 patients with TA, we identified 10 patients (0.87%) with AD, which was likely to be associated with vasculitis. All patients were females with a median age at TA onset of 26.5 years (range: 18.3-33.3 years), had type III TA and had a history of hypertension, which was much more common than that in previously reported cases. Stanford type B or DeBakey category III was the dominant anatomic classification of AD. Four patients developed AD after the diagnosis of TA, and 6 developed AD near the time of TA diagnosis. Nine patients underwent conservative treatment, whereas 1 patient underwent endovascular repair due to extensive dissection. At a median 70.5-month follow-up (range: 31.5-138.5), we found that 7 patients had no AD progression, 1 patient had progressed without symptoms, 1 patient was lost and 1 patient died. Conclusions Patients with TA along with long-standing and poorly controlled hypertension are liable to develop AD. Those with extensive AD in TA should be carefully treated and intensively followed up.

      PubDate: 2017-03-24T00:03:20Z
      DOI: 10.1016/j.amjms.2017.01.010
       
  • Food Allergy: What We Know Now
    • Authors: Lindsey E. Moore; Patricia H. Stewart; Richard D. deShazo
      Pages: 353 - 366
      Abstract: Publication date: April 2017
      Source:The American Journal of the Medical Sciences, Volume 353, Issue 4
      Author(s): Lindsey E. Moore, Patricia H. Stewart, Richard D. deShazo
      Food allergy is an adverse immune reaction that occurs reproducibly on exposure to a given food. Prevalence rates of food allergy continue to increase worldwide, sparking continual research efforts in finding a suitable and safe cure. Food avoidance, the current standard of care, can be difficult to achieve. This review aims to provide a broad overview of immunoglobulin E–mediated food allergy, highlighting its epidemiology, masqueraders, immunopathophysiology, clinical presentation, diagnostic work-up and available preventative and treatment strategies. This review also discusses novel, investigative therapies that offer promising therapeutic options, yet require continued research efforts to determine safety effects. Inducing tolerance, whether by immunotherapy or by the administration of monoclonal antibodies, allows us to move toward a cure for food allergy, which could vastly change this field of allergic diseases in the coming decades.

      PubDate: 2017-03-24T00:03:20Z
      DOI: 10.1016/j.amjms.2016.11.014
       
  • Cap-Assisted Colonoscopy Increases Detection of Advanced Adenomas and
           Polyps
    • Authors: Mohamed O. Othman; Daniel Zhang; Sherif Elhanafi; Mohamed Eloliby; Brian Davis; Richard Guererro; Luis Alvarado; Linda Sanchez; Alok Dwivedi; Marc J. Zuckerman
      Pages: 367 - 373
      Abstract: Publication date: April 2017
      Source:The American Journal of the Medical Sciences, Volume 353, Issue 4
      Author(s): Mohamed O. Othman, Daniel Zhang, Sherif Elhanafi, Mohamed Eloliby, Brian Davis, Richard Guererro, Luis Alvarado, Linda Sanchez, Alok Dwivedi, Marc J. Zuckerman
      Background Cap-assisted colonoscopy (CAC) has been reported to increase the adenoma detection rate (ADR) in Asian population. However, CAC trials in non-Asian population have had conflicting results. Studies in North America have shown an improvement in ADRs with the use of CAC, but it mainly included white and African American patients. Given the lack of prospective studies of CAC in Hispanics, we conducted this randomized controlled trial. Materials and Methods This is a randomized controlled trial comparing CAC with standard colonoscopy (SC) in patients undergoing screening or surveillance colonoscopy. Our primary outcome was the ADR. Secondary outcomes were polyp detection rate, mean polyp and ADR, advanced ADR (AADR) and detection rates based on polyp morphology and location. Results A total of 440 patients were included in the study (88.5% Hispanic). Cecal and terminal ileum intubation rates were similar in both groups (CAC: 97% and 86% versus SC: 99% and 81%, respectively). CAC did not improve ADR in comparison with SC (0.65 versus 0.52; P = 0.079); however, CAC had a higher AADR in comparison with SC (9.9% versus 4.6%; P = 0.049). CAC detected significantly more pedunculated polyps as compared with flat and sessile polyps (P = 0.011). Complication rates were similar in the CAC and SC groups (0.9% versus 0%). Conclusions In a predominantly Hispanic population, no difference was seen in the mean ADR with the use of CAC. However, CAC, when compared with SC, resulted in an increased AADR and mean polyp detection rate.

      PubDate: 2017-03-24T00:03:20Z
      DOI: 10.1016/j.amjms.2017.01.015
       
  • Relationship Among Pulmonary Hypertension, Autoimmunity, Thyroid Hormones
           and Dyspnea in Patients With Hyperthyroidism
    • Authors: Sayid Shafi Zuhur; Derya Baykiz; Sonat Pinar Kara; Ertan Sahin; Idris Kuzu; Gulsah Elbuken
      Pages: 374 - 380
      Abstract: Publication date: April 2017
      Source:The American Journal of the Medical Sciences, Volume 353, Issue 4
      Author(s): Sayid Shafi Zuhur, Derya Baykiz, Sonat Pinar Kara, Ertan Sahin, Idris Kuzu, Gulsah Elbuken
      Objective Previous studies have reported conflicting results regarding the mechanisms underlying the pathophysiology of pulmonary hypertension (PHT) in patients with hyperthyroidism. Therefore, in this study, we investigated the association between PHT and thyroid-stimulating hormone (TSH) receptor antibody, thyroid peroxidase antibody, thyroglobulin antibody, TSH, fT3, fT4 and dyspnea during daily activities in a large population of patients with hyperthyroidism. Methods A total of 129 consecutive patients with hyperthyroidism, 37 with hypothyroidism and 38 euthyroid controls were enrolled in this study. The modified medical research council scale was used for the assessment of dyspnea in daily activities. All the patients and euthyroid controls underwent transthoracic echocardiography for the assessment of PHT. Results Mild PHT was present in 35%, 36%, 13.5% and 5% of the patients with Graves׳ disease, toxic multinodular goiter, hypothyroidism and euthyroid controls, respectively. Pulmonary vascular resistance (PVR) was higher in hyperthyroid patients with PHT than in those without PHT. Moreover, a significant positive correlation was found between modified medical research council scale and pulmonary artery systolic pressure as well as PVR in patients with hyperthyroidism. No association was found between PHT and serum TSH receptor antibody, thyroid peroxidase antibody, thyroglobulin antibody, TSH, fT3 and fT4 levels. Conclusions Mild PHT is present in a significant proportion of patients with hyperthyroidism, regardless of etiology. PVR appears to be the main cause of PHT in patients with hyperthyroidism, and neither autoimmunity nor thyroid hormones are associated with PHT in these patients. Mild dyspnea during daily activities in patients with hyperthyroidism may be related to PHT; however, severe dyspnea requires further evaluation.

      PubDate: 2017-03-24T00:03:20Z
      DOI: 10.1016/j.amjms.2017.01.016
       
  • One-Year Survival is Not Affected by Gastrointestinal Bleeding After
           Percutaneous Coronary Interventions
    • Authors: Kyari Sumayin Ngamdu; Wael El Mallah; Alok Dwivedi; Rabab Mohsin; Sherif Elhanafi; Yi Jia; Luis A. Alvarado; Debabrata Mukherjee; Marc J. Zuckerman
      Pages: 381 - 386
      Abstract: Publication date: April 2017
      Source:The American Journal of the Medical Sciences, Volume 353, Issue 4
      Author(s): Kyari Sumayin Ngamdu, Wael El Mallah, Alok Dwivedi, Rabab Mohsin, Sherif Elhanafi, Yi Jia, Luis A. Alvarado, Debabrata Mukherjee, Marc J. Zuckerman
      Background Percutaneous coronary intervention (PCI) has been the main therapy in acute coronary syndromes, and early antithrombotic agents as well as 1-year dual antiplatelet therapy are required for adjuvant therapy. However, the development of post-PCI gastrointestinal (GI) bleeding may increase all-cause mortality. We compared the characteristics and outcomes of patients with GI bleeding within 1 year after PCI to those who did not develop bleeding. Methods A retrospective cohort study was conducted using data from 384 PCI procedures performed between January 2011 and December 2013 at our hospital. End points were identified after 30 days, 90 days and 1 year postprocedure for evidence of GI bleeding or new onset anemia. Variables were compared between patients with and without GI bleeding using t test and Fisher exact test. Kaplan-Meier curve was constructed for estimating bleeding-free survival probability. Results In a more than 1-year follow-up period, there were 39 cases (10.2%, 95% CI: 0.073-0.136) of documented GI bleeds. Females were found to have a significantly higher frequency of GI bleeding than males (16.8% vs. 8.0%, P = 0.018), and Hispanics more than non-Hispanics (11.7% vs. 1.7%, P = 0.017). All patients with GI bleeding survived at 1 year. Conclusion In our study of a predominantly Hispanic population, a high incidence of GI bleeding after PCI occurred. However, there was no association between the incidence of GI bleeding and all-cause mortality, whether PCI was performed in the setting of acute coronary syndrome or as an elective procedure. There is a need to conduct a larger prospective study to validate the findings of our study.

      PubDate: 2017-03-24T00:03:20Z
      DOI: 10.1016/j.amjms.2017.01.017
       
  • Preclinical Medical Student Note Quality
    • Authors: Erin Contratto; Todd Peterson; Carlos A. Estrada
      Pages: 387 - 388
      Abstract: Publication date: April 2017
      Source:The American Journal of the Medical Sciences, Volume 353, Issue 4
      Author(s): Erin Contratto, Todd Peterson, Carlos A. Estrada


      PubDate: 2017-03-24T00:03:20Z
      DOI: 10.1016/j.amjms.2016.08.019
       
  • Outcomes of Percutaneous Closure of Patent Ductus Arteriosus Accompanied
           With Unilateral Absence of Pulmonary Artery
    • Authors: Yankun Yang; Hong Zheng; Zhongying Xu; Gejun Zhang; Jinglin Jin; Haibo Hu; Tao Tian; Xianliang Zhou
      Pages: 389 - 393
      Abstract: Publication date: April 2017
      Source:The American Journal of the Medical Sciences, Volume 353, Issue 4
      Author(s): Yankun Yang, Hong Zheng, Zhongying Xu, Gejun Zhang, Jinglin Jin, Haibo Hu, Tao Tian, Xianliang Zhou
      Background Limited data have reported the outcomes of percutaneous closure of patent ductus arteriosus (PDA) in patients with unilateral absence of pulmonary artery (UAPA). This study aimed to evaluate the symptomatology, diagnosis and therapy, especially the transcatheter closure of PDA in patients with PDA associated with UAPA. Materials and Methods Patients diagnosed with PDA and UAPA were retrospectively enrolled from August 2010 through January 2016. Clinical data, treatment and follow-up information were evaluated. Results Thirteen patients (6 males and 7 females) were diagnosed with PDA associated with UAPA. Percutaneous closure was successfully conducted in 6 patients successfully. The median age was 7 years (7 months to 37 years). The mean diameter of the PDA and occluders were 4.7 ± 1.8mm (2-7mm) and 11.3 ± 3.9mm (6-14mm), respectively. The mean pulmonary artery pressure was 41.5 ± 13.5mmHg (25-62mmHg). The diameter of PDA has no relationship with the degree of pulmonary artery pressure (r = 0.239, P = 0.648). In 4 patients, systolic pulmonary arterial pressure decreased significantly after closure with 69.0 ± 10.7 versus 48.0 ± 11.3mmHg (P = 0.146), and also the mean pulmonary arterial pressure was 54.5 ± 5.7 mm Hg versus 30.5 ± 3.9mmHg (P = 0.04). In all, 1 patient had a trace residual shunt, which disappeared within 24 hours. Conclusions In appropriate patients with PDA associated with UAPA, transcatheter closure of PDA has the potential to improve the pulmonary artery hypertension. Further follow-up is required to monitor the long-term outcomes.

      PubDate: 2017-03-24T00:03:20Z
      DOI: 10.1016/j.amjms.2017.01.018
       
  • Mycobacterium kansasii Infection in a Patient Receiving Biologic
           Therapy—Not All Reactive Interferon Gamma Release Assays Are
           Tuberculosis
    • Authors: Nasir Saleem; Raya Saba; Srikanth Maddika; Mitchell Weinstein
      Pages: 394 - 397
      Abstract: Publication date: April 2017
      Source:The American Journal of the Medical Sciences, Volume 353, Issue 4
      Author(s): Nasir Saleem, Raya Saba, Srikanth Maddika, Mitchell Weinstein
      Mycobacterium kansasii, a nontuberculous mycobacterium, can lead to lung disease similar to tuberculosis. Immunotherapeutic biologic agents predispose to infections with mycobacteria, including M kansasii. T-cell–mediated interferon gamma release assays like QuantiFERON-TB Gold Test (QFT) are widely used by clinicians for the diagnosis of infections with Mycobacterium tuberculosis; however, QFT may also show positive result with certain nontuberculous mycobacterial infections. We report a case of M kansasii pulmonary infection, with a positive QFT, in an immunocompromised patient receiving prednisone, leflunomide and tocilizumab, a humanized anti–interleukin-6 receptor monoclonal antibody. This case highlights the risk of mycobacterial infections with the use of various biologic agents and the need for caution when interpreting the results of interferon gamma release assays.

      PubDate: 2017-03-24T00:03:20Z
      DOI: 10.1016/j.amjms.2016.03.001
       
  • Oliver Cromwell׳s Fatal Ague
    • Authors: Sanjay Saint; Thomas Cogswell; Eliot Siegel; Philip A. Mackowiak
      Pages: 398 - 401
      Abstract: Publication date: April 2017
      Source:The American Journal of the Medical Sciences, Volume 353, Issue 4
      Author(s): Sanjay Saint, Thomas Cogswell, Eliot Siegel, Philip A. Mackowiak
      Although many people recognize Oliver Cromwell by name, few know more than the barest details of his life or his legacy, and fewer still of the “ague” that ended his brief reign as Lord Protector of the Commonwealth of England, Scotland and Ireland and one of Britain׳s greatest generals. He died suddenly at age 59. Cromwell was the “terror of Europe” during that period. His physicians diagnosed his fatal disorder as “bastard tertian ague.” A contemporary analysis of his clinical record, including one with the aid of the U.S. Department of Energy׳s supercomputer at the Oak Ridge National Laboratory in Tennessee, suggests that he died of an infection, possibly 2 infections acting in concert.

      PubDate: 2017-03-24T00:03:20Z
      DOI: 10.1016/j.amjms.2016.11.024
       
  • Lactic Acidosis: A Rare Oncological Emergency in Solid Tumors at
           Presentation
    • Authors: Ranjit Nair; Usman Shah
      Pages: 402 - 406
      Abstract: Publication date: April 2017
      Source:The American Journal of the Medical Sciences, Volume 353, Issue 4
      Author(s): Ranjit Nair, Usman Shah
      Lactic acidosis is a potentially life-threatening complication characterized by accumulation of blood lactate resulting in low arterial pH. The majority of lactic acidosis in malignancies are reported in association with hematologic malignancies. It may result from an imbalance between lactate production and hepatic lactate utilization, but the exact pathophysiology is far more complex than what we can fathom from current micromolecular studies. We report a case of a 71-year-old male with metastatic lung cancer presenting with fatal lactic acidosis in the absence of liver involvement. Review of the literature reveals only 27 reported cases of solid tumors presenting with lactic acidosis, of which nearly all of them had extensive liver metastasis. Patients were treated with aggressive fluid resuscitation, bicarbonate administration and hemodialysis, but the only effective treatment modality was early aggressive chemotherapy initiation.

      PubDate: 2017-03-24T00:03:20Z
      DOI: 10.1016/j.amjms.2016.05.001
       
  • Actinomyces neuii Causing Vertebral Osteomyelitis
    • Authors: Kelly Pizzo; Christopher Arnold; Brian Wispelwey
      Pages: 407 - 410
      Abstract: Publication date: April 2017
      Source:The American Journal of the Medical Sciences, Volume 353, Issue 4
      Author(s): Kelly Pizzo, Christopher Arnold, Brian Wispelwey


      PubDate: 2017-03-24T00:03:20Z
      DOI: 10.1016/j.amjms.2016.08.017
       
  • Nicorandil-Induced Hyperkalemia in a Hemodialysis Patient
    • Authors: Hsiu-Ting Chen; Yu-Te Wu; Wu-Chang Yang; Der-Cherng Tarng; Chih-Ching Lin
      Pages: 411 - 412
      Abstract: Publication date: April 2017
      Source:The American Journal of the Medical Sciences, Volume 353, Issue 4
      Author(s): Hsiu-Ting Chen, Yu-Te Wu, Wu-Chang Yang, Der-Cherng Tarng, Chih-Ching Lin


      PubDate: 2017-03-24T00:03:20Z
      DOI: 10.1016/j.amjms.2016.10.004
       
  • A Dark Bronchoalveolar Lavage Fluid
    • Authors: José Baddini-Martinez; Luis Renato Alves; Simone Gusmão Ramos
      First page: 413
      Abstract: Publication date: April 2017
      Source:The American Journal of the Medical Sciences, Volume 353, Issue 4
      Author(s): José Baddini-Martinez, Luis Renato Alves, Simone Gusmão Ramos


      PubDate: 2017-03-24T00:03:20Z
      DOI: 10.1016/j.amjms.2016.06.010
       
  • A Depressed Heart: Atrial Fibrillation and Pulmonary Hypertension in
           Severe Pectus Excavatum
    • Authors: Sumit Som; Tatyana Danilov
      Pages: 414 - 415
      Abstract: Publication date: April 2017
      Source:The American Journal of the Medical Sciences, Volume 353, Issue 4
      Author(s): Sumit Som, Tatyana Danilov


      PubDate: 2017-03-24T00:03:20Z
      DOI: 10.1016/j.amjms.2016.09.016
       
  • Gastric Cancer Associated With Malignant Acanthosis Nigricans
    • Authors: Wan-Bin Yin; Yuan Gao; Yun Lu
      First page: 416
      Abstract: Publication date: April 2017
      Source:The American Journal of the Medical Sciences, Volume 353, Issue 4
      Author(s): Wan-Bin Yin, Yuan Gao, Yun Lu


      PubDate: 2017-03-24T00:03:20Z
      DOI: 10.1016/j.amjms.2016.08.029
       
  • Pyogenic Liver Abscess Due to Fusobacterium nucleatum in a Patient With
           Liver Hemangiomas
    • Authors: Theodoros Karantanos; Styliani Karanika; Kenechukwu Obiokoye; Meg Sullivan; Christine Phillips; Sonia Ananthakrishnan
      Pages: 417 - 418
      Abstract: Publication date: April 2017
      Source:The American Journal of the Medical Sciences, Volume 353, Issue 4
      Author(s): Theodoros Karantanos, Styliani Karanika, Kenechukwu Obiokoye, Meg Sullivan, Christine Phillips, Sonia Ananthakrishnan


      PubDate: 2017-03-24T00:03:20Z
      DOI: 10.1016/j.amjms.2016.07.008
       
  • Cardiac Invasion by a Mixed Germ Cell Tumor
    • Authors: Haitham S. Al Ashry; Jeremy Richards
      First page: 419
      Abstract: Publication date: April 2017
      Source:The American Journal of the Medical Sciences, Volume 353, Issue 4
      Author(s): Haitham S. Al Ashry, Jeremy Richards


      PubDate: 2017-03-24T00:03:20Z
      DOI: 10.1016/j.amjms.2016.06.008
       
  • Plasmodium Falciparum Exflagellation in a Patient with Ovalocytosis
    • Abstract: Publication date: Available online 20 April 2017
      Source:The American Journal of the Medical Sciences
      Author(s): Mamadou Alpha Diallo, Khadim Diongue, Daouda Ndiaye


      PubDate: 2017-04-20T23:58:05Z
       
  • Overexpression of Heparin-binding Epidermal Growth Factor-like Growth
           Factor Mediates Liver Fibrosis in Transgenic Mice
    • Abstract: Publication date: Available online 20 April 2017
      Source:The American Journal of the Medical Sciences
      Author(s): Yongze Guo, Qian Ding, Lei Chen, Chenguang Ji, Huiyao Hao, Jia Wang, Wei Qi, Xiaoli Xie, Junji Ma, Aidi Li, Xiaoyu Jiang, Xiaotian Li, Huiqing Jiang
      Background The role of heparin-binding epidermal growth factor-like growth factor (HB-EGF) in liver fibrosis is not clear and is sometimes even contradictory. To clarify this role, a HB-EGF transgenic (Tg) mouse model was, for the first time, used to evaluate the functions of HB-EGF in liver fibrosis. Methods For the in vivo study, carbon tetrachloride (CCl4) injection and bile duct ligation (BDL) treatment were used to induce liver fibrosis in HB-EGF Tg mice and wild-type (WT) mice, respectively. Primary hepatic satellite cells (HSCs) were isolated from HB-EGF Tg and WT mice for the in vitro study. Results Compared with the WT mice, HB-EGF Tg mice were shown to develop more severe liver fibrosis when treated with CCl4 or bile duct ligation (BDL), with increased MMP-13 activity and enhanced expression of fibrogenic genes including α-smooth muscle actin (α-SMA) and collagen I. HB-EGF gene transfer led to an increase in proliferation and a decrease in apoptosis in primary HSCs. The ERK signaling pathway was more highly activated in primary HSCs from HB-EGF Tg mice than in those from WT mice. Conclusion Our investigation confirmed the profibrotic effect of HB-EGF on the liver using a transgenic mouse model. This result may contribute to the elucidation of HB-EGF as a therapeutic target in liver fibrosis.

      PubDate: 2017-04-20T23:58:05Z
       
  • Fenofibrate Attenuates Hypertension in Goldblatt Hypertensive Rats: Role
           of 20-Hydroxyeicosatetraenoic Acid in the Nonclipped Kidney
    • Authors: Alexandra Libor; Kopkan Zdenka Elzbieta Kompanowska-Jezierska Janusz Sadowski Hana
      Abstract: Publication date: Available online 12 April 2017
      Source:The American Journal of the Medical Sciences
      Author(s): Alexandra Sporková, Věra Čertíková Chábová, Šárka Doleželová, Šárka Jíchová, Libor Kopkan, Zdenka Vaňourková, Elzbieta Kompanowska-Jezierska, Janusz Sadowski, Hana Maxová, Luděk Červenka
      Background There is vast evidence that the renin-angiotensin system is not the sole determinant of blood pressure (BP) elevation in human renovascular hypertension or the relevant experimental models. This study tested the hypothesis that kidney deficiency of 20-hydroxyeicosatetraenoic acid (20-HETE), a product of cytochrome P450 (CYP)-dependent ω-hydroxylase pathway of arachidonic acid (AA) metabolism, is important in the pathophysiology of the maintenance phase of two-kidney, one-clip (2K1C) Goldblatt hypertension. Methods In 2K1C Goldblatt rats with established hypertension, angiotensin II (ANG II), angiotensin-(1–7) (ANG 1–7), 20-HETE concentrations, and gene expression of CYP4A1 enzyme (responsible for 20-HETE formation) of the nonclipped kidney were determined. We examined if 14 days′ administration of fenofibrate, a lipid-lowering drug, would increase CYP4A1 gene expression and renal 20-HETE formation, and if increased 20-HETE concentrations in the nonclipped kidney would decrease blood pressure (BP) (telemetric measurements). Results CYP4A1 gene expression, 20-HETE and ANG 1–7 concentrations were lower and ANG II levels were higher in the nonclipped kidney of 2K1C rats than in sham-operated rats. Fenofibrate increased CYP4A1 gene expression and 20-HETE concentration in the nonclipped kidney and significantly decreased BP in 2K1C rats but did not restore it to normotensive range. The treatment did not change BP in sham-operated rats. Conclusion Our results suggest that alterations in the RAS and CYP-dependent ω-hydroxylase metabolites of AA in the nonclipped kidneys are both important in the pathophysiology of the maintenance phase of 2K1C Goldblatt hypertension. Therefore, fenofibrate treatment effectively attenuated hypertension, probably via stimulation of 20-HETE formation in the nonclipped kidney.

      PubDate: 2017-04-13T16:16:39Z
       
  • Predictive factors and treatment outcomes of tuberculous pleural effusion
           in cancer patients with pleural effusion
    • Authors: Jaehee Lee; Yong Dae Lee; Jae Kwang Lim; Deok Heon Lee; Seung Soo Yoo; Shin Yup Lee; Seung Ick Cha; Jae Yong Park; Chang Ho Kim
      Abstract: Publication date: Available online 11 April 2017
      Source:The American Journal of the Medical Sciences
      Author(s): Jaehee Lee, Yong Dae Lee, Jae Kwang Lim, Deok Heon Lee, Seung Soo Yoo, Shin Yup Lee, Seung Ick Cha, Jae Yong Park, Chang Ho Kim
      Objectives Patients with cancer are at increased risk of tuberculosis. As pleural effusion has great clinical significance in patients with cancer, the differential diagnosis between tuberculous pleural effusion (TPE) and malignant pleural effusion (MPE) is important. However, the predictive factors and treatment outcomes of TPE in cancer patients have rarely been studied. Methods Confirmed TPE cases identified at cancer diagnosis and during anti-cancer management from 2008 to 2015 were retrospectively investigated. Control groups were MPE patients, and TPE patients without cancer. Clinical, laboratory, and pleural fluid characteristics were compared among groups. Treatment outcomes were compared between TPE patients with and without cancer. Results Patients in the study included coexisting TPE and cancer (n=20), MPE (n=40), and TPE without cancer (n=40). In the final analysis, serum C-reactive protein (S-CRP) ≥3.0mg/dL and pleural fluid adenosine deaminase (ADA) ≥40 U/L were independent predictors for identifying TPE in cancer patients with pleural effusion. The combination of S-CRP with pleural fluid ADA using an “or” rule achieved a sensitivity of 100%, whereas both parameters combined in an “and” rule had a specificity of 98%. Treatment outcomes were not different between the TPE groups with and without cancer. Conclusions S-CRP and pleural fluid ADA levels may be helpful for predicting TPE in patients with cancer with pleural effusion. The combination of these biomarkers provides better information for distinguishing between TPE and MPE in these patients. Treatment outcomes of TPE in patients with cancer are comparable to those in patients without cancer.

      PubDate: 2017-04-13T16:16:39Z
      DOI: 10.1016/j.amjms.2017.04.006
       
  • Coarctation of Aorta with Classical Imaging Findings
    • Authors: Alireza Movahed; David Majdalany
      Abstract: Publication date: Available online 10 April 2017
      Source:The American Journal of the Medical Sciences
      Author(s): Alireza Movahed, David Majdalany


      PubDate: 2017-04-13T16:16:39Z
      DOI: 10.1016/j.amjms.2017.04.003
       
  • Potential Cardiovascular and Renal Protective Effects of Vitamin D and
           Coenzyme Q10 in L- NAME Induced Hypertensive Rats: Add -on Therapy
    • Authors: Hanan A. Shamardl; Sahar M. El-Ashmony; Hala F. Kamel; Sameer H. Fatani
      Abstract: Publication date: Available online 10 April 2017
      Source:The American Journal of the Medical Sciences
      Author(s): Hanan A. Shamardl, Sahar M. El-Ashmony, Hala F. Kamel, Sameer H. Fatani
      Background Hypertension is one of the primary modifiable risk factors for cardiovascular disease. Adequate vitamin D levels have been shown to reduce vascular smooth muscle contraction and to increase arterial compliance, which may be beneficial in hypertension. Further, coenzymeQ10 (COQ10) through its action to lower oxidative stress has been reported to have beneficial effects on hypertension and heart failure. The current study examined the possible cardiac and renal protective effects of vitamin D and COQ10 both separately and in combination with an angiotensin II receptor blocker, valsartan in L-NAME hypertensive rats. Methods Hypertension was induced in rats by L-NAME administration. Following induction of hypertension, the rats were assigned into 6 subgroups: L-NAME alone and treated groups receiving the following drugs intraperitoneally for 6 weeks; valsartan, vitamin D, COQ10 and combination of valsartan with either vitamin D or COQ10. A group of normotensive rats were used as negative controls. At the end of the treatment period, blood pressure, serum creatinine, BUN, lipids and serum, cardiac and renal parameters of oxidative stress were measured. Results Compared to the L-NAME only group, all treatments lowered systolic, diastolic, mean arterial pressure, total cholesterol, LDL-C, creatinine levels as well as TNF-α and Malondialdehyde. Further, the agents increased serum, cardiac and renal total antioxidant capacity. Interestingly, the combination of agents had further effects on all the parameters compared to treatment with each single agent. Conclusions The study suggests that the additive protective effects of vitamin D and COQ10 when used alone or concurrent with valsartan treatment in hypertensive rats, may be due to their effects as antioxidants, anti-cytokines and blood pressure conservers.

      PubDate: 2017-04-13T16:16:39Z
      DOI: 10.1016/j.amjms.2017.04.007
       
  • Pulmonary Mucormycosis in a Patient with Poorly Controlled Diabetes Post
           Liver Transplant
    • Authors: William R. Hunt
      Abstract: Publication date: Available online 8 April 2017
      Source:The American Journal of the Medical Sciences
      Author(s): William R. Hunt


      PubDate: 2017-04-13T16:16:39Z
      DOI: 10.1016/j.amjms.2017.03.035
       
  • Hypocomplementemic Urticarial Vasculitis Syndrome with Crescentic
           Glomerulonephritis: Case Report and Review of Literature
    • Authors: Sohail Abdul Salim; Tauqeer Yousuf; Asha Patel; Tibor Fülöp; Mohit Agarwal
      Abstract: Publication date: Available online 8 April 2017
      Source:The American Journal of the Medical Sciences
      Author(s): Sohail Abdul Salim, Tauqeer Yousuf, Asha Patel, Tibor Fülöp, Mohit Agarwal
      Hypocomplementemic urticarial vasculitis syndrome (HUVS) is a rare autoimmune disease characterized by multiple organ system involvement, including renal disease, with low complement levels. We report the case of a 31-year-old female who presented with non-specific symptoms including fatigue, diarrhea, macular rash and abdominal pain with acute renal failure leading to end-stage kidney disease. Laboratory results showed hematuria, nephrotic range proteinuria, worsening creatinine and low C1q levels. Left kidney biopsy showed proliferative glomerulonephritis with crescent formation. She was treated with 6 months of intravenous (IV) cyclophosphamide, followed by 2 doses of IV rituximab (1 gm each), thereafter maintained on mycophenolate-mofetil and glucocorticoid-based therapy. She experienced a full recovery of renal function after 12 months of dialysis dependence. HUVS with crescentic glomerulonephritis is a rare disease with only 5 other reported cases in literature. In our case, we document a delayed but excellent renal recovery during a 2-year follow-up.

      PubDate: 2017-04-13T16:16:39Z
      DOI: 10.1016/j.amjms.2017.04.004
       
  • Paraganglioma of the Urinary Bladder: A Rare Cause of Hypertension and
           Urinary Tract Infections
    • Authors: Gerard Chaaya; Jorge Morales; Analia Castiglioni; Noman Subhani; Abdo Asmar
      Abstract: Publication date: Available online 8 April 2017
      Source:The American Journal of the Medical Sciences
      Author(s): Gerard Chaaya, Jorge Morales, Analia Castiglioni, Noman Subhani, Abdo Asmar
      Pheochromocytoma is a neoplasm, which develops from cells of the chromaffin tissues that are derived from the ectodermic neural system and mostly situated within the adrenal medulla. About 15% of pheochromocytoma cases arise from extra-adrenal chromaffin tissue. Pheochromocytoma of the bladder is rare and accounts for less than 0.06% of all bladder neoplasm and less than 1% of all pheochromocytoma. We report a case of a young woman who presented with uncontrolled hypertension, recurrent urinary tract infections, and micturition attacks and was found to have a metastatic bladder paraganglioma. In addition, we provide a summary table of the clinical manifestations of paragangliomas based on anatomical locations.

      PubDate: 2017-04-13T16:16:39Z
      DOI: 10.1016/j.amjms.2017.03.037
       
  • Soluble CD14 subtype, a new biomarker in predicting outcome of critically
           ill septic patients: an observational prospective study
    • Authors: Giovanni Matera; Angela Quirino; Cinzia Peronace; Pio Settembre; Vito Marano; Maria T. Loria; Nadia Marascio; Luisa Galati; Giorgio S. Barreca; Aida Giancotti; Bruno Amantea; Maria C. Liberto; Alfredo Focà
      Abstract: Publication date: Available online 7 April 2017
      Source:The American Journal of the Medical Sciences
      Author(s): Giovanni Matera, Angela Quirino, Cinzia Peronace, Pio Settembre, Vito Marano, Maria T. Loria, Nadia Marascio, Luisa Galati, Giorgio S. Barreca, Aida Giancotti, Bruno Amantea, Maria C. Liberto, Alfredo Focà
      Background We evaluated the role of presepsin (soluble CD14 subtype, sCD14-ST) in predicting outcome of critically ill septic patients, in parallel with procalcitonin (PCT) and C-reactive protein (CRP). Methods This study was an observational prospective study that enrolled 58 surgical and medical ICU patients with suspected sepsis. All studied subjects were retrospectively stratified in survivors and non-survivors based on 28 days survival, and according to microbiological results in blood culture-positive and –negative groups. Plasma and serum samples from each patient were collected at admission (T-0), after 24–48hours (T-1) and following 7 days (T-2). Statistics were following Student t test and ANOVA plus Bonferroni post-hoc test. ROC analysis was also performed. Results Presepsin levels were significantly higher at T-0 ( p= 0.0007), at T-1 ( p< 0.0001) and at T-2 (p< 0.0001) in non-survivors vs. survivors at the same time point. Presepsin concentrations were significantly increased at T-0 (p=0.0073), T1(p=0.0111) and T2 (p= 0.0167) in blood culture-positive patients in comparison to culture-negative patients at the same time. Presepsin data from dead/alive individuals were subjected to ROC analysis, which demonstrated an excellent accuracy and significant AUROCC (p<0.0001) at all the times evaluated. Results of multivariate analysis indicated presepsin as a predictive independent variable among prognosis markers at T-0 (p=0.016). Conclusions Presepsin revealed an optimal prognostic performance in severe septic patients and provided interesting diagnostic value. Prediction of outcome in critical patients is crucial to optimize management decisions and level of treatment.

      PubDate: 2017-04-13T16:16:39Z
      DOI: 10.1016/j.amjms.2017.03.036
       
  • Pro-brain natriuretic peptide and Troponin T-hypersensitivity levels
           correlate with the severity of liver dysfunction in liver cirrhosis
    • Authors: Jiancheng Zhao; Sai Li; Linan Ren; Xiaozhong Guo; Xingshun Qi
      Abstract: Publication date: Available online 7 April 2017
      Source:The American Journal of the Medical Sciences
      Author(s): Jiancheng Zhao, Sai Li, Linan Ren, Xiaozhong Guo, Xingshun Qi
      Background and aims Increased pro brain natriuretic peptide (pro-BNP) or troponin T-hypersensitivity (TnT-HSST) levels are common in liver cirrhosis. A retrospective observational study aimed to evaluate the correlation of pro-BNP and TnT-HSST levels with the clinical characteristics, laboratory data, and in-hospital outcomes in Chinese patients with liver cirrhosis. Methods We selected cirrhotic patients admitted to our hospital between January 2011 and June 2014. All eligible patients had pro-BNP and/or TnT-HSST data. The pro-BNP and TnT-HSST data were further divided according to the presence of cardiac diseases. Results The prevalence of pro-BNP level>900pg/ml was 41.72% (63/151). The prevalence of TnT-HSST level>0.05ng/ml was 11.22% (45/401). In the overall analysis, pro-BNP level significantly correlated with red blood cell (RBC), platelet (PLT), ascites, blood urea nitrogen (BUN), creatinine (Cr), Child-Pugh score, MELD score, and in-hospital death; TnT-HSST level significantly correlated with white blood cell (WBC), ascites, albumin (ALB), BUN, Cr, Child-Pugh score, MELD score, and in-hospital death. In patients with cardiac diseases, pro-BNP level significantly correlated with RBC, ascites, BUN, Cr, Child-Pugh score, and MELD score; TnT-HSST level significantly correlated with sex, ascites, WBC, ALB, BUN, Cr, Child-Pugh score, MELD score, and in-hospital death. In patients without cardiac diseases, pro-BNP level significantly correlated with ascites, RBC, PLT, BUN, Cr, MELD score, and in-hospital death; TnT-HSST level significantly correlated with age, ascites, RBC, ALB, BUN, Cr, Child-Pugh score, MELD score, and in-hospital death. Conclusion Pro-BNP and TnT-HSST levels significantly correlated with the severity of liver dysfunction and in-hospital mortality in cirrhosis.

      PubDate: 2017-04-13T16:16:39Z
      DOI: 10.1016/j.amjms.2017.04.005
       
  • A Case Series and Systematic Review of Urinothorax
    • Authors: Adam Austin; Sidharth Navin Jogani; Paul Bradley Brasher; Rahul Gupta Argula; John Terrill Huggins; Amit Chopra
      Abstract: Publication date: Available online 7 April 2017
      Source:The American Journal of the Medical Sciences
      Author(s): Adam Austin, Sidharth Navin Jogani, Paul Bradley Brasher, Rahul Gupta Argula, John Terrill Huggins, Amit Chopra
      Urinothorax is an uncommon thoracic complication of genitourinary (GU) tract disease, which is most frequently caused by obstructive uropathy, but may also occur as a result of iatrogenic or traumatic GU injury. It is under recognized due to a perceived notion as to the rarity of the diagnosis and the absence of established diagnostic criteria. Urinothorax is typically described as a pauci-cellular, transudative pleural effusion with a pleural fluid/serum creatinine (PF/S Cr) ratio > 1.0. It is the only transudate associated with pleural fluid acidosis (pH < 7.40). When the pleural fluid analysis (PFA) demonstrates features of a transudate, pH < 7.40 and a PF/S Cr > 1.0, a confident clinical diagnosis of urinothorax can be established. A Technetium 99m renal scan can be considered a confirmatory test in patients that lack the typical PFA features or fail to demonstrate evidence of obstructive uropathy that can be identified via conventional radiographic modalities. Management of a urinothprax requires a multidisciplinary approach with an emphasis on the correction of the underlying GU tract pathology, and once corrected, this often leads to a rapid resolution of the pleural effusion.

      PubDate: 2017-04-13T16:16:39Z
      DOI: 10.1016/j.amjms.2017.03.034
       
  • Plasma Antiphospholipid Antibodies Effects on Activated Partial
           Thromboplastin Time Assays
    • Authors: Ke Yao; Lingyun Zhang; Hang Zhou; Ning Tang; Dengju Li
      Abstract: Publication date: Available online 6 April 2017
      Source:The American Journal of the Medical Sciences
      Author(s): Ke Yao, Lingyun Zhang, Hang Zhou, Ning Tang, Dengju Li
      Background Activated partial thromboplastin time (aPTT) assays can be affected by plasma antiphospholipid antibodies (aPLs), but the degree of the interference is not easy to predict. This study aimed to investigate the effects on aPTT assay results of different types and combinations of aPLs, including anti-β2-glycoprotein-I (anti-β2GPI) antibodies, anticardiolipin antibodies (aCLs) and lupus anticoagulant (LA). Methods We retrospectively collected clinical information and laboratory tests from aPL-positive patients. The potential influence of aPLs on aPTT assays was assessed. Results The survey included 589 aPL-positive patients. No significant differences existed in basic characteristics such as sex, age, prothrombin time (PT), fibrinogen (Fbg), and alanine aminotransferase (ALT), among different cases with one, two or three types of positive aPL markers (p>0.05). In 113 patients with abnormal aPTT values, multivariable linear regression analysis showed a significant correlation between an abnormal degree of aPTT values and dRVVT(dilute Russell viper venom time) or SCT(silica clotting time) with a correlation coefficient of 0.437 or 0.497 (p<0.01), whereas age, aCL-IgG, aCL-IgM and anti-β2GPI antibodies were of no significance (p>0.05). Among blood samples with three types of aPLs positivity, the rate of abnormal aPTT detection values was 55.3%, which was significantly higher than that observed in patients with negative, single-positive, or double-positive aPL markers (p<0.05). Patients with a moderate-to-strong dRVVT or SCT had a higher proportion of abnormal aPTT assays than did patients with a low dRVVT or SCT (p<0.05). Conclusion When abnormal aPTT values are obtained, the influence of aPLs should be considered, especially in the presence of a moderate-to-strong dRVVT or SCT.

      PubDate: 2017-04-07T10:23:03Z
      DOI: 10.1016/j.amjms.2017.03.031
       
  • The Effects of Pleural Plaques on Longitudinal Lung Function in Libby,
           Montana Vermiculite Miners
    • Authors: Kathleen A. Clark; J. Jay Flynn; Wilfried J.J. Karmaus; Lawrence C. Mohr
      Abstract: Publication date: Available online 6 April 2017
      Source:The American Journal of the Medical Sciences
      Author(s): Kathleen A. Clark, J. Jay Flynn, Wilfried J.J. Karmaus, Lawrence C. Mohr
      Rationale Assess associations of pleural plaques and longitudinal lung function in Libby vermiculite miners occupationally exposed to asbestos. Background High resolution computed tomography (HRCT) was used to identify asbestos related findings in former Libby vermiculite miners. We investigated annual lung function decline in miners with pleural plaques only, and compared them to miners with normal HRCT findings. Methods HRCTs from 128 miners were categorized into four diagnostic groups: 1. normal CT scan (n=9), 2. pleural plaques only (n=72); 3. pleural plaques and interstitial fibrosis (n=26); or 4. additional HRCT abnormalities (n=21) such as: rounded atelectasis, diffuse pleural thickening, pleural effusions, or pulmonary nodules or tumor > 1cm in diameter. Random intercept and slope linear mixed-effect regression models identified differences in lung function decline between miners with asbestos associated outcomes and those with normal HRCT. Models were adjusted for follow-up time, BMI, smoking status, latent exposure period, and employment years. Interactions for smoking status with age and smoking status with pleural plaque severity were examined. Main Results Miners with pleural plaques only, did not have an accelerated decline in lung function between 40–80 years. Miners with pleural plaques and additional HRCT abnormalities displayed significantly accelerated declines in FEV1 and DLCO (p=0.05 and p<0.01, respectively). Plaque severity did not affect lung function decline. However, smokers with extensive plaques displayed accelerated loss in DLCO and FEV1 when compared to nonsmoking miners with mild plaque formation. Conclusion Pleural plaques alone did not significantly affect lung function decline in Libby vermiculite miners.

      PubDate: 2017-04-07T10:23:03Z
      DOI: 10.1016/j.amjms.2017.03.033
       
  • Lymphocyte-Variant Hypereosinophilic Syndrome with Eosinophilic
           Myocarditis Treated with Steroids and Pegylated Interferon Alpha 2a
    • Authors: Christopher C. Cheung; Maggie Constantine; Amir Ahmadi; Carolyn Shiau; Luke Y.C. Chen
      Abstract: Publication date: Available online 6 April 2017
      Source:The American Journal of the Medical Sciences
      Author(s): Christopher C. Cheung, Maggie Constantine, Amir Ahmadi, Carolyn Shiau, Luke Y.C. Chen


      PubDate: 2017-04-07T10:23:03Z
      DOI: 10.1016/j.amjms.2017.03.030
       
  • Triglyceride to HDL Cholesterol Ratio and Cardiovascular Events in
           Diabetics with Coronary Artery Disease
    • Authors: Sheng-Hua Yang; Ying Du; Xiao-Lin Li; Yan Zhang; Sha Li; Rui-Xia Xu; Cheng-Gang Zhu; Yuan-Lin Guo; Na-Qiong Wu; Ping Qing; Ying Gao; Chuan-Jue Cui; Qian Dong; Jing Sun; Jian-Jun Li
      Abstract: Publication date: Available online 6 April 2017
      Source:The American Journal of the Medical Sciences
      Author(s): Sheng-Hua Yang, Ying Du, Xiao-Lin Li, Yan Zhang, Sha Li, Rui-Xia Xu, Cheng-Gang Zhu, Yuan-Lin Guo, Na-Qiong Wu, Ping Qing, Ying Gao, Chuan-Jue Cui, Qian Dong, Jing Sun, Jian-Jun Li
      Introduction It has been demonstrated that elevated triglycerides (TG) to high-density lipoprotein cholesterol (HDL-C) ratio is a risk factor of coronary artery disease (CAD) in patients with type 2 diabetes mellitus (T2DM) and is also found to be associated with cardiovascular events (CVEs) in general population. However, its prognostic value in T2DM patients with CAD remains to be determined. Methods A total of 1,447 consecutive T2DM patients with angiographic-proven stable CAD were enrolled in the present study and followed up for an average of 20.3 months. The characteristics of all patients including fasting lipid profile were obtained at baseline and multivariate Cox-proportional hazards models were constructed using log TG/HDL-C as a predictor variable. The relationships between CVEs and total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), non-HDL-C, TC/HDL-C, LDL-C/HDL-C, and apoB/apoAI were also explored. Results Compared with the patients without CVEs, the ones who experienced CVEs had higher TG/HDL-C ratio. Univariable regression revealed a significant association of log TG/HDL-C with CVEs (hazard ratio [HR] =2.5, p=0.015). After adjusting for multiple traditional risk factors of cardiovascular disease (CVD), the association was still found (HR=2.47, p=0.047). Moreover, results suggested that the ratios of non–HDL-C, TC/HDL-C, LDL-C/HDL-C and apoB/apoAI were not predictors for CVEs in T2DM. Conclusions In our primary study data suggested that elevated TG/HDL-C value might be a useful predictor for future CVEs in Chinese T2DM patients with stable CAD. Further study is needed to confirm our findings.

      PubDate: 2017-04-07T10:23:03Z
      DOI: 10.1016/j.amjms.2017.03.032
       
  • Eosinophilic Myocarditis: A Concise Review for Clinicians
    • Authors: Christopher C. Cheung; Maggie Constantine; Amir Ahmadi; Carolyn Shiau; Luke Y.C. Chen
      Abstract: Publication date: Available online 6 April 2017
      Source:The American Journal of the Medical Sciences
      Author(s): Christopher C. Cheung, Maggie Constantine, Amir Ahmadi, Carolyn Shiau, Luke Y.C. Chen
      Persistent eosinophilia can cause cardiac tissue damage, typically in the form of eosinophilic myocarditis, whether the underlying cause is reactive, a clonal myeloid disorder, or idiopathic hypereosinophilic syndrome (HES). Eosinophilic myocarditis (EM) ranges from mild localized disease to multifocal widespread infiltrates associated with myocardial necrosis, thrombotic complications and endomyocardial fibrosis. Systemic treatment varies widely depending on the underlying cause, so thorough investigation and precise diagnosis are essential. Evaluation includes assessment for reactive causes of eosinophilia (vasculitis such as EGPA/Churg-Strauss, parasitic infection, autoimmune disease, IgG4-related disease, medications and other causes), genetic lesions characteristic of clonal myeloid disorders (PDGFRα and PDGFRβ and FGFR1) and flow cytometry and molecular studies for the aberrant T-cells characteristic of lymphocyte-variant hypereosinophilic syndrome (L-HES). Patients with reactive eosinophilia require treatment for the underlying cause, such as anti-parasitic therapy for helminthic infection or immunosuppression for EGPA/Churg-Strauss. Those with a myeloid clone often benefit from the tyrosine kinase inhibitor imatinib. Steroids are first line treatment for idiopathic HES and L-HES and hydroxyurea or (pegylated) interferon-α may be used for relapsed or refractory disease. Mepolizumab, an anti-interleukin-5 monoclonal antibody, is an effective steroid-sparing agent in HES but is not widely available for this indication.

      PubDate: 2017-04-07T10:23:03Z
      DOI: 10.1016/j.amjms.2017.04.002
       
  • Is Decreased MPV in Allergic Airway Diseases Associated with Extent of The
           Inflammation Area?
    • Authors: Recep Akgedik; Yasin Yağız
      Abstract: Publication date: Available online 6 April 2017
      Source:The American Journal of the Medical Sciences
      Author(s): Recep Akgedik, Yasin Yağız
      Objective The aim of this study was to determine the relationship between MPV level and the extent of airway inflammation in allergic airway diseases and in sub-groups by comparison of inflammatory markers. Methods A retrospective examination was made of 250 patients with allergic airway disease in the symptomatic phase, who had been newly-diagnosed or who had abandoned treatment for at least 6 months. These patients were separated into 3 groups of asthma without allergic rhinitis (A-AR, n=107), asthma with allergic rhinitis (A+AR, n=83) and allergic rhinitis without asthma (AR-A, n=60). Results MPV values of the study groups were found to be statistically significantly lower than those of the control group (p<0.001). MPV was determined to be negatively correlated with WBC, neutrophil count, platelet count and IgE level in the study groups. The lowest MPV value was determined in the A+AR group (8.035±1.05fL), which had the most extensive airway involvement, and the highest MPV value was determined in the AR-A group (8.109±1.11fL) with the least airway involvement. MPV level sensitivity and the specificity of the best cut-off level were 74,5 % and 40,8 %, respectively. The cut-off level of 8,18fL for MPV level was found to have moderate sensitivity and low specificity for predicting PE. Conclusion The results of this study showed that MPV is lower in allergic airway diseases and a negative correlation was determined between MPV and inflammation markers but no statistically significant difference was determined between MPV and extent of the inflammation area.

      PubDate: 2017-04-07T10:23:03Z
      DOI: 10.1016/j.amjms.2017.04.001
       
  • Safety and Effectiveness of Indwelling Pleural Catheters for Non-Malignant
           Effusions: Evidence-Based Answers to Clinical Concerns
    • Authors: David Maurice Chambers; Bilal Abaid; Umair Gauhar
      Abstract: Publication date: Available online 4 April 2017
      Source:The American Journal of the Medical Sciences
      Author(s): David Maurice Chambers, Bilal Abaid, Umair Gauhar
      Pleural effusions occur in 1.5 million patients yearly and are a common cause of dyspnea. For non-malignant effusions, initial treatment is directed at the underlying cause, but when effusions become refractory to medical therapy, palliative options are limited. Tunneled pleural catheters are commonly used for palliation of malignant effusions, but many clinicians are reluctant to recommend these devices for palliation of non-malignant effusions, citing concerns of infection, renal failure, electrolyte disturbances, and protein loss malnutrition. Based on the published experience to date, tunneled pleural catheters relieve dyspnea and can result in spontaneous pleurodesis in patients with non-malignant effusions. The infection rate compares favorably to that for malignanteffusions with possible increased risk in hepatic hydrothorax and post-transplant patients. Renal failure, electrolyte disturbance, and protein loss malnutrition have not been observed. Tunneled pleural catheters are a reasonable option in select patients to palliate non-malignant effusions refractory to maximal medical therapy.

      PubDate: 2017-04-07T10:23:03Z
      DOI: 10.1016/j.amjms.2017.03.003
       
  • Congenital Descending Aorta-Pulmonary Vein Fistula
    • Authors: Tingting Wu; Yiming Yu; Yun Zhang; Zaichun Deng
      Abstract: Publication date: Available online 30 March 2017
      Source:The American Journal of the Medical Sciences
      Author(s): Tingting Wu, Yiming Yu, Yun Zhang, Zaichun Deng


      PubDate: 2017-03-30T09:25:11Z
      DOI: 10.1016/j.amjms.2017.02.005
       
  • Prognostic Value of Ventricular Wall Motion Score and GRACE Score in Acute
           Mocardial Infarction Patients
    • Authors: Li Xiang; Maosong Wang; Tao You; Yang Jiao; Jianchang Chen; Weiting Xu
      Abstract: Publication date: Available online 23 March 2017
      Source:The American Journal of the Medical Sciences
      Author(s): Li Xiang, Maosong Wang, Tao You, Yang Jiao, Jianchang Chen, Weiting Xu
      Objective The aim of this study was to evaluate the prognostic values of ventricular wall motion score (WMS) and global registry of acute coronary events (GRACE) score in patients with acute myocardial infarction (AMI) in a 12-month single center prospective cohort. Methods Consecutive inpatients diagnosed with AMI in the department of cardiology of the second affiliated hospital of Soochow University from September 2012 through March 2015 were enrolled in this study. Echocardiography was issued to all subjects to calculate WMS within 24hours after admission, and GRACE score of each patient was obtained simultaneously. During a 12-month follow-up period, all major adverse cardiac events (MACE) were recorded. Results After 12 months of observation period, 124 out of 635 AMI patients developed MACE. The WMS (23.70±3.80 vs 20.47±3.25) and GRACE score (185.59±45.16 vs 152.19±36.51) were significantly higher in patients with MACE than those without MACE (P<0.05). Survival analysis using Cox regression revealed that both WMS (95%CI: 1.082~1.184, P<0.05) and GRACE score (95%CI: 1.010 ~1.021, P<0.05) independently predicted MACE. The receiver operator curve (ROC) curve analysis showed that the area under curve (AUC) of WMS, GRACE score and the combination of WMS and GRACE score were 0.768  (P<0.05), 0.718 (P<0.05) and 0.812 (P<0.05), respectively. Conclusion WMS and GRACE score were independent predictors of MACE in patients with AMI in 12-month follow up, and the combined application of WMS and GRACE score can significantly improve the predictive value.

      PubDate: 2017-03-24T00:03:20Z
      DOI: 10.1016/j.amjms.2017.03.029
       
  • A Rarely Recognized Cause of Acute Kidney Injury in Rhabdomyolysis
    • Authors: José Antonio Tesser Poloni; Mark A. Perazella
      Abstract: Publication date: Available online 22 March 2017
      Source:The American Journal of the Medical Sciences
      Author(s): José Antonio Tesser Poloni, Mark A. Perazella


      PubDate: 2017-03-24T00:03:20Z
      DOI: 10.1016/j.amjms.2017.03.028
       
  • Cannabinoids and Symptomatic Bradycardia
    • Authors: Mark R. Heckle; Mannu Nayyar; Scott E. Sinclair; Karl T. Weber
      Abstract: Publication date: Available online 22 March 2017
      Source:The American Journal of the Medical Sciences
      Author(s): Mark R. Heckle, Mannu Nayyar, Scott E. Sinclair, Karl T. Weber
      Cannabinoids, the bioactive components of marijuana, have adverse cardiovascular consequences, including symptomatic sinus bradycardia, sinus arrest and ventricular asystole. Physicians should be aware of these deleterious consequences that can appear in otherwise healthy persons who are chronic marijuana users.

      PubDate: 2017-03-24T00:03:20Z
      DOI: 10.1016/j.amjms.2017.03.027
       
  • Risk Factors and Outcomes of Acute Kidney Injury in Patients with
           HBV-related Acute-On-Chronic Liver failure
    • Authors: Wei Yuan; Yu-yi Zhang; Zheng-guo Zhang; Ying Zou; Hong-zhou Lu; Zhi-ping Qian
      Abstract: Publication date: Available online 21 March 2017
      Source:The American Journal of the Medical Sciences
      Author(s): Wei Yuan, Yu-yi Zhang, Zheng-guo Zhang, Ying Zou, Hong-zhou Lu, Zhi-ping Qian
      Background Acute kidney injury (AKI) is common in patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF); however, few studies concerning the risk factors and recovery patterns of renal function have been published. Materials and Methods A retrospective analysis of 150 HBV-ACLF patients was performed. The occurrence, risk factors and functional recovery of AKI among HBV-ACLF patients were investigated. Results A total of 90 patients (60%) with HBV-ACLF developed AKI. Patients with AKI had higher creatine kinase (P=0.004), total bilirubin (P=0.039), HBV viral load (P=0.044), serum creatine (P<0.001) and model for end-stage liver disease (MELD) score (P<0.001) values and a higher proportion of hepatic encephalopathy (P=0.032) and spontaneous bacterial peritonitis (SBP) (P=0.042) than patients without AKI. Logistic regression analysis illustrated that SBP (OR=6.214, P=0.012) and MELD score (OR=1.097, P=0.006) were risk factors for the development of AKI. A subgroup analysis of recovery patterns in renal function showed that patients with a severe AKI stage had worse outcomes (P=0.007). The proportion of patients who experienced a complete recovery was higher in survivors than in the overall AKI populations (P=0.004). Follow-up studies showed that the no-AKI group had a higher transplant-free survival rate than the AKI group at day 90 (80.0% vs 26.7%, respectively, P<0.001). The survival rate among patients with AKI stage 1 was higher than that of AKI stage 2 patients and AKI stage 3 patients (P<0.001). Conclusion AKI is common in patients with HBV-ACLF. The SBP and MELD score have some prognosis value for patients with AKI. AKI and its stages affect the 90-day transplant-free mortality rate. It is important to focus on exploring the early recognition of AKI and early intervention of those risk factors in HBV-ACLF individuals.

      PubDate: 2017-03-24T00:03:20Z
      DOI: 10.1016/j.amjms.2017.03.005
       
  • Islamic Medicine in the Middle Ages
    • Authors: Hawa Edriss; Brittany N Rosales; Connie Nugent; Christian Conrad; Kenneth Nugent
      Abstract: Publication date: Available online 18 March 2017
      Source:The American Journal of the Medical Sciences
      Author(s): Hawa Edriss, Brittany N Rosales, Connie Nugent, Christian Conrad, Kenneth Nugent
      The Islamic culture flourished between the 9th and 13th centuries. Scholars from this era made significant contributions in mathematics, science, and medicine. Caliphs and physicians built hospitals which provided universal care and the foundation for medical education. Physician-scientists made significant advances in medical care, surgery, and pharmacology. Notable authorities include al-Razi (865–925) who wrote the Kitab al-Hawi fi al-tibb (The Comprehensive Book on Medicine), a 23-volume textbook that provided the main medical curriculum for European schools into the 14th century. Ibn Sina (980–1037), an extraordinary Persian polymath, wrote al Qanun fi al-Tibb (The Canon of Medicine), an encyclopedic treatment of medicine that combined his own observations with medical information from Galen and philosophy from Aristotle. Mansur (1380–1422) wrote the first color illustrated book on anatomy. Other important physicians compiled information on the use of medication from plants, advanced surgical techniques, including cataract extraction, and studied physiology, including the pulmonary circulation. These books and ideas provided the basis for medical care in Europe during its recovery from the Dark Ages.

      PubDate: 2017-03-24T00:03:20Z
      DOI: 10.1016/j.amjms.2017.03.021
       
  • Actinomyces Peritonitis: A Unique Therapy and Case Review
    • Authors: Coulon Aaron; Kamat Rahul; Jaikishen Ashwin; Naljayan Mihran
      Abstract: Publication date: Available online 18 March 2017
      Source:The American Journal of the Medical Sciences
      Author(s): Coulon Aaron, Kamat Rahul, Jaikishen Ashwin, Naljayan Mihran


      PubDate: 2017-03-24T00:03:20Z
      DOI: 10.1016/j.amjms.2017.03.026
       
  • Presentation of 2017 SSCI Founder′s Medal
    • Authors: Jesse Roman; Sushma K. Cribbs
      Abstract: Publication date: Available online 18 March 2017
      Source:The American Journal of the Medical Sciences
      Author(s): Jesse Roman, Sushma K. Cribbs


      PubDate: 2017-03-24T00:03:20Z
      DOI: 10.1016/j.amjms.2017.03.018
       
  • 11β-Hydroxysteroid Dehydrogenase Type 1 in Obese Subjects with T2DM
    • Authors: Xia Li; Jingli Wang; Qin Yang; Shiying Shao
      Abstract: Publication date: Available online 16 March 2017
      Source:The American Journal of the Medical Sciences
      Author(s): Xia Li, Jingli Wang, Qin Yang, Shiying Shao
      Obesity is one of the most important contributors to the development of type 2 diabetes mellitus (T2DM). Tissue specific glucocorticoids (GCs) regulated by 11β-hydroxysteroid dehydrogenase enzyme (11β-HSD) type 1 is involved in central obesity and obesity related comorbidities. Moderate down-regulation of 11β-HSD1 can attenuate insulin insensitivity and the impairment of glucose-stimulated insulin secretion (GSIS). Some of the beneficial effects of 11β-HSD1 inhibition may be mediated, at least in part, through inactivation of tissue specific GC action related to insulin signaling mechanisms, alleviation of abnormal cytokine profile, and the improvement of β-cell function. Thus, 11β-HSD1 is a promising target for treatment and prevention of T2DM with obesity.

      PubDate: 2017-03-18T00:38:26Z
      DOI: 10.1016/j.amjms.2017.03.023
       
 
 
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