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Publisher: Elsevier   (Total: 3184 journals)

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Showing 1 - 200 of 3184 Journals sorted alphabetically
Academic Pediatrics     Hybrid Journal   (Followers: 37, SJR: 1.655, CiteScore: 2)
Academic Radiology     Hybrid Journal   (Followers: 26, SJR: 1.015, CiteScore: 2)
Accident Analysis & Prevention     Partially Free   (Followers: 100, SJR: 1.462, CiteScore: 3)
Accounting Forum     Hybrid Journal   (Followers: 28, SJR: 0.932, CiteScore: 2)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 39, SJR: 1.771, CiteScore: 3)
Achievements in the Life Sciences     Open Access   (Followers: 6)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 7)
Acta Astronautica     Hybrid Journal   (Followers: 433, SJR: 0.758, CiteScore: 2)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 2)
Acta Biomaterialia     Hybrid Journal   (Followers: 28, SJR: 1.967, CiteScore: 7)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription   (Followers: 3)
Acta de Investigación Psicológica     Open Access   (Followers: 3)
Acta Ecologica Sinica     Open Access   (Followers: 11, SJR: 0.18, CiteScore: 1)
Acta Histochemica     Hybrid Journal   (Followers: 3, SJR: 0.661, CiteScore: 2)
Acta Materialia     Hybrid Journal   (Followers: 305, 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: 2, 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: 25, 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: 7, SJR: 0.19, CiteScore: 0)
Actualites Pharmaceutiques Hospitalieres     Full-text available via subscription   (Followers: 3)
Acupuncture and Related Therapies     Hybrid Journal   (Followers: 8)
Acute Pain     Full-text available via subscription   (Followers: 15, SJR: 2.671, CiteScore: 5)
Ad Hoc Networks     Hybrid Journal   (Followers: 11, SJR: 0.53, CiteScore: 4)
Addictive Behaviors     Hybrid Journal   (Followers: 17, SJR: 1.29, CiteScore: 3)
Addictive Behaviors Reports     Open Access   (Followers: 9, SJR: 0.755, CiteScore: 2)
Additive Manufacturing     Hybrid Journal   (Followers: 11, SJR: 2.611, CiteScore: 8)
Additives for Polymers     Full-text available via subscription   (Followers: 23)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 181, SJR: 4.09, CiteScore: 13)
Advanced Engineering Informatics     Hybrid Journal   (Followers: 12, SJR: 1.167, CiteScore: 4)
Advanced Powder Technology     Hybrid Journal   (Followers: 17, SJR: 0.694, CiteScore: 3)
Advances in Accounting     Hybrid Journal   (Followers: 9, SJR: 0.277, CiteScore: 1)
Advances in Agronomy     Full-text available via subscription   (Followers: 17, SJR: 2.384, CiteScore: 5)
Advances in Anesthesia     Full-text available via subscription   (Followers: 29, 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: 11, 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: 15, 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: 9, 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: 5)
Advances in Cellular and Molecular Biology of Membranes and Organelles     Full-text available via subscription   (Followers: 14)
Advances in Chemical Engineering     Full-text available via subscription   (Followers: 29, 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: 26, SJR: 1.562, CiteScore: 3)
Advances in Colloid and Interface Science     Full-text available via subscription   (Followers: 20, 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: 13)
Advances in Digestive Medicine     Open Access   (Followers: 12)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 7)
Advances in Drug Research     Full-text available via subscription   (Followers: 26)
Advances in Ecological Research     Full-text available via subscription   (Followers: 43, SJR: 2.524, CiteScore: 4)
Advances in Engineering Software     Hybrid Journal   (Followers: 29, SJR: 1.159, CiteScore: 4)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 8)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 51, 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: 65, SJR: 0.591, CiteScore: 2)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 17)
Advances in Genetics     Full-text available via subscription   (Followers: 21, SJR: 1.354, CiteScore: 4)
Advances in Genome Biology     Full-text available via subscription   (Followers: 10, SJR: 12.74, CiteScore: 13)
Advances in Geophysics     Full-text available via subscription   (Followers: 7, SJR: 1.193, CiteScore: 3)
Advances in Heat Transfer     Full-text available via subscription   (Followers: 26, SJR: 0.368, CiteScore: 1)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 11, SJR: 0.749, CiteScore: 3)
Advances in Human Factors/Ergonomics     Full-text available via subscription   (Followers: 24)
Advances in Imaging and Electron Physics     Full-text available via subscription   (Followers: 3, 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: 10, 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: 6, SJR: 0.176, CiteScore: 0)
Advances in Intl. Accounting     Full-text available via subscription   (Followers: 3)
Advances in Life Course Research     Hybrid Journal   (Followers: 9, 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: 20, SJR: 0.88, CiteScore: 2)
Advances in Mathematics     Full-text available via subscription   (Followers: 12, SJR: 3.027, CiteScore: 2)
Advances in Medical Sciences     Hybrid Journal   (Followers: 8, SJR: 0.694, CiteScore: 2)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 6)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 5, SJR: 1.158, CiteScore: 3)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 24)
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: 5)
Advances in Oncobiology     Full-text available via subscription   (Followers: 2)
Advances in Organ Biology     Full-text available via subscription   (Followers: 2)
Advances in Organometallic Chemistry     Full-text available via subscription   (Followers: 18, 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: 27, SJR: 0.461, CiteScore: 1)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 18)
Advances in Pharmacology     Full-text available via subscription   (Followers: 17, SJR: 1.536, CiteScore: 3)
Advances in Physical Organic Chemistry     Full-text available via subscription   (Followers: 9, 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: 10)
Advances in Plant Pathology     Full-text available via subscription   (Followers: 6)
Advances in Porous Media     Full-text available via subscription   (Followers: 5)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 19)
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: 66)
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: 418, 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: 13, SJR: 0.555, CiteScore: 2)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 37, SJR: 2.208, CiteScore: 4)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 20)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 15)
Advances in Virus Research     Full-text available via subscription   (Followers: 5, SJR: 2.262, CiteScore: 5)
Advances in Water Resources     Hybrid Journal   (Followers: 53, SJR: 1.551, CiteScore: 3)
Aeolian Research     Hybrid Journal   (Followers: 6, SJR: 1.117, CiteScore: 3)
Aerospace Science and Technology     Hybrid Journal   (Followers: 380, 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: 12, SJR: 3.671, CiteScore: 9)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 469, 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: 45, SJR: 1.272, CiteScore: 3)
Agriculture and Agricultural Science Procedia     Open Access   (Followers: 4)
Agriculture and Natural Resources     Open Access   (Followers: 3)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 58, SJR: 1.747, CiteScore: 4)
Ain Shams Engineering J.     Open Access   (Followers: 5, SJR: 0.589, CiteScore: 3)
Air Medical J.     Hybrid Journal   (Followers: 7, SJR: 0.26, CiteScore: 0)
AKCE Intl. J. of Graphs and Combinatorics     Open Access   (SJR: 0.19, CiteScore: 0)
Alcohol     Hybrid Journal   (Followers: 12, SJR: 1.153, CiteScore: 3)
Alcoholism and Drug Addiction     Open Access   (Followers: 11)
Alergologia Polska : Polish J. of Allergology     Full-text available via subscription   (Followers: 1)
Alexandria Engineering J.     Open Access   (Followers: 2, 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: 10, SJR: 0.201, CiteScore: 1)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 54, SJR: 4.66, CiteScore: 10)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 6, SJR: 1.796, CiteScore: 4)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 6, SJR: 1.108, CiteScore: 3)
Ambulatory Pediatrics     Hybrid Journal   (Followers: 5)
American Heart J.     Hybrid Journal   (Followers: 58, SJR: 3.267, CiteScore: 4)
American J. of Cardiology     Hybrid Journal   (Followers: 63, SJR: 1.93, CiteScore: 3)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 46, SJR: 0.604, CiteScore: 1)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 12)
American J. of Geriatric Psychiatry     Hybrid Journal   (Followers: 14, SJR: 1.524, CiteScore: 3)
American J. of Human Genetics     Hybrid Journal   (Followers: 37, SJR: 7.45, CiteScore: 8)
American J. of Infection Control     Hybrid Journal   (Followers: 29, SJR: 1.062, CiteScore: 2)
American J. of Kidney Diseases     Hybrid Journal   (Followers: 36, SJR: 2.973, CiteScore: 4)
American J. of Medicine     Hybrid Journal   (Followers: 50)
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: 247, SJR: 2.7, CiteScore: 4)
American J. of Ophthalmology     Hybrid Journal   (Followers: 66, 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: 32, 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: 39, 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: 66, SJR: 0.138, CiteScore: 0)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 24, SJR: 0.411, CiteScore: 1)
Anales de Cirugia Vascular     Full-text available via subscription   (Followers: 1)
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: 44, SJR: 1.512, CiteScore: 5)
Analytica Chimica Acta : X     Open Access  
Analytical Biochemistry     Hybrid Journal   (Followers: 208, SJR: 0.633, CiteScore: 2)
Analytical Chemistry Research     Open Access   (Followers: 13, SJR: 0.411, CiteScore: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 14)
Anesthésie & Réanimation     Full-text available via subscription   (Followers: 2)
Anesthesiology Clinics     Full-text available via subscription   (Followers: 25, 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: 218, SJR: 1.58, CiteScore: 3)
Animal Feed Science and Technology     Hybrid Journal   (Followers: 6, SJR: 0.937, CiteScore: 2)
Animal Reproduction Science     Hybrid Journal   (Followers: 7, SJR: 0.704, CiteScore: 2)

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Similar Journals
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  [3184 journals]
  • Pentazocine-induced Skin Ulcers
    • Abstract: Publication date: Available online 11 September 2019Source: The American Journal of the Medical SciencesAuthor(s): Kamal Kant Sahu, Gitesh Upendra Sawatkar, Shamendra Anand Sahu, Ajay Kumar Mishra, Amos Lal
       
  • The Natural History of Iron Deficiency Anemia
    • Abstract: Publication date: Available online 31 August 2019Source: The American Journal of the Medical SciencesAuthor(s): Samuel Dickey, Don C. Rockey BackgroundCurrent evidence suggests that adult men and non-menstruating women with iron deficiency anemia (IDA) should undergo gastrointestinal (GI) evaluation to detect a potential bleeding lesion. We hypothesized that after endoscopic evaluation and treatment, IDA would be expected to resolve. Thus, we aimed to understand the natural history of IDA, in particular long-term outcomes.MethodsAdult patients with IDA (defined as anemia and ferritin
       
  • Update on diabetes technology: Are we ready to move beyond capillary
           glucose testing and insulin injections'
    • Abstract: Publication date: Available online 30 August 2019Source: The American Journal of the Medical SciencesAuthor(s): Rodolfo J. Galindo, Alexandra L. Migdal, Guillermo E. Umpierrez
       
  • Insulin Pumps: Review of Technological Advancement in Diabetes Management
    • Abstract: Publication date: Available online 28 August 2019Source: The American Journal of the Medical SciencesAuthor(s): Nicoleta D. Sora, Fnu Shashpal, Elizabeth A. Bond, Alicia J. Jenkins Insulin pump therapy, also known as continuous subcutaneous insulin infusion (CSII) therapy is an evolving form of insulin delivery which has been shown to be highly effective in maintaining euglycemia and providing patients with flexibility in their lives. It functions by providing the patient with a continuous subcutaneous infusion of a rapid acting insulin and allows the patient to administer boluses throughout the day for food and correction of high glucose levels. CSII is approved in patients with type 1 diabetes and selected patients with type 2 diabetes; however, it is important to select the right patients for pump therapy. Insulin pump technology continues to rapidly evolve, and many options are now on the market, including those that are used in conjunction with continuous glucose monitoring. This review article focuses on the pros and cons of CSII therapy as well as the technical and clinical considerations in starting a patient on this therapy.
       
  • Disseminated Dermal Gout
    • Abstract: Publication date: Available online 27 August 2019Source: The American Journal of the Medical SciencesAuthor(s): Jasmeet Gill, Mark Feldman
       
  • Why Did the United States Medical School Admissions Quota for Jews
           End'
    • Abstract: Publication date: Available online 26 August 2019Source: The American Journal of the Medical SciencesAuthor(s): Edward C. Halperin At the end of World War II anti-Semitism was pervasive in the United States. Quotas to limit the number of Jewish students were put in place at most U.S. medical schools in the 1920s and were well-entrenched by 1945. By 1970 the quota was gone. Why'Multiple factors contributed to the end of the quota. First, attitudes towards Jews shifted as Americans recoiled from the horrors of the Holocaust and over half a million Jewish GIs returned home from World War II. Many entered the higher education system.Second, governmental and private investigations in New York City, New York State, and Philadelphia exposed the quota. Third, New York State, led by Governor Thomas E. Dewey, established four publicly supported non-discriminatory medical schools. These schools adsorbed many New York Jewish applicants. Fourth, from the 1920’s through the 1960’s some medical schools consistently or intermittently ignored the quota. Finally, the federal and several state governments passed non-discrimination in higher education legislation.The quotas ended because of a combination of changing societal attitudes and government and private social action. This remarkable social change may be instructive as higher education now grapples with allegations of a quota system for Asian-Americans.
       
  • An exceptional case of bilateral atrophic squirrhus of breast
    • Abstract: Publication date: Available online 24 August 2019Source: The American Journal of the Medical SciencesAuthor(s): Wala Ben Kridis, Afef Khanfir
       
  • Abnormal Chest Radiograph in Asymptomatic Patient: Intrapericardial
           Herniation of Colon
    • Abstract: Publication date: Available online 14 August 2019Source: The American Journal of the Medical SciencesAuthor(s): Adam Austin, Wafic Itani, Curtis Adams, Scott H. Beegle
       
  • Choosing To Use Care As A Verb, Rather Than A Noun
    • Abstract: Publication date: Available online 14 August 2019Source: The American Journal of the Medical SciencesAuthor(s): Edward C. Halperin
       
  • Mapping the Mutation Landscape of Colorectal Cancer
    • Abstract: Publication date: Available online 14 August 2019Source: The American Journal of the Medical SciencesAuthor(s): Kimberly J. Newsom, Petr Starostik
       
  • Lung to Lung Cannonball Metastasis
    • Abstract: Publication date: Available online 12 August 2019Source: The American Journal of the Medical SciencesAuthor(s): Chun-Hsien He, Yu-Jang Su
       
  • Beware energy drinks: A case of a toxic triad syndrome in a diabetic
           patient with non-alcoholic fatty disease
    • Abstract: Publication date: Available online 2 August 2019Source: The American Journal of the Medical SciencesAuthor(s): Gabriel I. Uwaifo Energy drinks are widely used and very popular. They are touted as “harmless” energy boosters for use in professional, recreational and domestic settings. They are typically high in monosaccharides, and caffeine with other assorted products like ginseng. Careful study of the potential risks of their use are nonexistent while rigorous documentation of their touted energy boosting capacity is also meagre. We present the cautionary case of a 46-year-old Caucasian man with well controlled type 2 diabetes and non alcoholic fatty liver disease who developed a toxic triad syndrome of gastritis, hepatitis and pancreatitis within 4 months of commencing daily consumption of 2-3 160z cans of the energy drink Monster Energy. His clinical symptoms and biochemical derangements promptly resolved with stopping the beverage. We discuss the potential risks inherent in unsupervised liberal consumption of energy drinks and the need for both caution and vigilance among clinicians and patients.
       
  • Influenza with community-associated methicillin-resistant
           Staphylococcus aureus pneumonia
    • Abstract: Publication date: Available online 1 August 2019Source: The American Journal of the Medical SciencesAuthor(s): Chia-Wei Liu, Shih-Ping Lin, Wei-Yao Wang, Yen-Hsiang Huang Patients with community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) pneumonia had poor clinical outcomes and high frequency of mortality, especially in patents with post-influenza infection. Herein, we report a case of community-acquired pneumonia (CAP) with multiple organ failure in a 51-year-old patient with initial presentation of flu-like symptoms. The influenza rapid test from the specimen of nasopharyngeal swab was positive for type B influenza virus, and was confirmed by real-time polymerase chain reaction. Gram stain of bronchoalveolar lavage fluid revealed gram positive cocci in group. Both sputum and blood culture yielded MRSA. We identified the CA-MRSA was staphylococcal cassette chromosome mec type IV strain carried Panton–Valentine leukocidin gene. The patient made a complete recovery following an 8-week treatment course of linezolid, and was discharged with independent daily activity. According to our experience, linezolid may be a reasonable treatment choice for CA-MRSA pneumonia due to the virulence of exotoxins.
       
  • Discovery of aberrant alteration of genome in colorectal cancer by exome
           sequencing
    • Abstract: Publication date: Available online 1 August 2019Source: The American Journal of the Medical SciencesAuthor(s): Yuanzi Liang, Liejun Jiang, Xiaogang Zhong, Steven N. Hochwald, Yongsi Wang, Lihe Huang, Qiumiao Nie, Huayi Huang, Jun-Fa Xu BackgroundThis study analyzed multiple parameters including somatic single nucleotide variations (SNVs), InDels, significantly mutated genes (SMGs), copy number variations (CNVs), and frequently altered pathways aims to discover novel aberrances in the tumorigenesis of colorectal cancer (CRC).MethodsExome sequencing was performed on an Illumina platform to identify novel potential somatic variances in 34 paired tumor and adjacent normal tissues from 17 CRC patients. Results were compared with databases (dbSNP138, 1000 genomes SNP, Hapmap, COSMIC and ESP6500) and analyzed. MuSic software was used to identify SMGs.ResultsIn total, 1637 somatic SNVs in 17 analyzed tumors were identified. Only 7 SNVs were shared by more than 1 tumor, suggesting that over 99% of the analyzed SNVs were independent events. Mutation of KRAS p. G12D and ZNF717 p. L39V were the most common SNVs. Moreover, 10 SMGs namely KRAS, TP53, SMAD4, ZNF717, FBXW7, APC, ZNF493, CDR1, ARMC4 and SUMF2 were found. Among those, ZNF717, ZNF493, CDR1, ARMC4, and SUMF2 were novel frequent genes in CRC. For CNVs analysis, gains in 10q25.3, 1p31.1, 1q44, 10q23.33, 11p15.4, and 20q13.33, and loss of 3q21.3 and 3q29 were frequent aberrations identified in our results.ConclusionsWe frequently found novel genes ZNF717, ZNF493, CDR1, ARMC4, and SUMF2 and gains in 10q25.3, which may be functional mutation in CRC. The high frequency private events such as SNVs confirms the highly heterogeneous mutations found in CRCs. The mutated genes sites in different patients may vary significantly, which may also be more challenging for clinical treatment.
       
  • Association between IL-6 polymorphisms and diabetic nephropathy risk: a
           meta-analysis
    • Abstract: Publication date: Available online 31 July 2019Source: The American Journal of the Medical SciencesAuthor(s): Bin Chen, Meiyan Wu, Chongsen Zang, Yanhua Li, Zhonggao Xu BackgroundThe objective of this work was to evaluate the relevance of frequent IL-6 polymorphisms and diabetic nephropathy (DN) susceptibility by a systematic meta-analysis.MethodsThe included studies related to the relationship between IL-6 and DN risk were searched from Pubmed, Embase, and the Cochrane Library, and the Newcastle-Ottawa Scale was used to evaluate the study quality. A heterogeneity test was performed to determine the appropriate effect models based on the Q test and I2 statistic. Odds ratios with 95% confidence intervals were employed for determine the strength of associations. Afterwards, subgroup analysis was conducted to assess the effect of specific factors on the corresponding results. Additionally, publication bias and sensitivity analysis were also undertaken.ResultsIn total, 11 eligible articles were obtained. The meta-analysis revealed that the“C”allele of IL-6 rs1800795 was related to the decreased risk of DN (C vs. G: P = 0.0471). The“G”allele of IL-6 rs1800796 was predominately associated with higher DN risks (GG vs. CC: P = 0.0194; GG vs. CC+GC: P = 0.0196). The“C”allele of IL-6 rs1800797 was implicated with higher prevalence of DN (C vs. G: P = 0.0001; CC vs.GG: P = 0.0003; CC vs. GG+CG: P = 0.0227; CC+CG vs. GG: P = 0.0001) while IL-6 rs2069837 and rs2069840 were not correlated with the susceptibility to DN.ConclusionsThis meta-analysis indicated that IL-6 rs1800795, rs1800796 and rs1800797 played important roles in DN development while IL-6 rs2069837 and rs2069840 might not be related to DN.
       
  • Impact of Atrial Fibrillation on In-Hospital Outcomes in Patients with
           Diabetic Ketoacidosis
    • Abstract: Publication date: Available online 27 July 2019Source: The American Journal of the Medical SciencesAuthor(s): Yifeng Yang, Baoqiong Liu, Jiabei He, Sonali Gupta, Soumya Thumma, Yiming Luo, George Everett, Joseph Mattana BackgroundDiabetic ketoacidosis entails a huge health burden among patients with diabetes. Atrial fibrillation (AF) is the most common type of heart arrhythmia. This study aimed to evaluate the impact of atrial fibrillation on clinical outcomes in patients with diabetic ketoacidosis.MethodsUsing the 2012-2014 National Inpatient Sample database (NIS), we identified adult patients hospitalized with diabetic ketoacidosis as the principal discharge diagnosis. The identified admissions were stratified into two cohorts based on the atrial fibrillation presence. We used multivariable regression models and propensity score matching models to evaluate in-hospital mortality, length of stay, comorbidities, and in-hospital complications.ResultsThe study included 478,890 adult patients who were admitted for diabetic ketoacidosis in the year 2012-2014. A total of 467,780 (97.68%) had no atrial fibrillation and 11,125 (2.32%) had atrial fibrillation. In both multivariable regression models and propensity score matching models, compared with non-atrial fibrillation group, the atrial fibrillation group had higher in-hospital mortality rates (2.36[1.69-3.32], P < 0.001) and longer length of stay (5.5 vs 3.3 days, P < 0.001). Atrial fibrillation was also associated with a significantly higher incidence of complications including septic shock, pulmonary failure, mechanical ventilation, neurological failure, cerebral edema, acute kidney injury, acute hematologic failure, and cardiac arrest.ConclusionsAmong patients who were hospitalized for diabetic ketoacidosis, comorbid atrial fibrillation led to increasing in-hospital mortality rates and longer length of stay. A potential explanation was that atrial fibrillation increased the risk of in-hospital complications including respiratory failure with a more frequent requirement for mechanical ventilation, cardiac arrest, and metabolic encephalopathy.
       
  • SAPHO syndrome
    • Abstract: Publication date: Available online 27 July 2019Source: The American Journal of the Medical SciencesAuthor(s): Takanobu Hirosawa, Shinichi Katsukura, Taro Shimizu
       
  • IL-33/ST2 signaling promotes hepatocellular carcinoma cell stemness
           expansion through activating JNK pathway
    • Abstract: Publication date: Available online 24 July 2019Source: The American Journal of the Medical SciencesAuthor(s): Rongrong Zhao, Zeyuan Yu, Min Li, Yongning ZhouABSTRACTBackgroundInterleukin-33 (IL-33) has a variety of biological activities in different pathological models. However, the underlying effects of IL-33 on hepatocellular carcinoma (HCC) have not been fully elucidated. Therefore, we focused on investigating the biological effects of IL-33 on HCC stemness expansion.MethodsIL-33 expression in clinical tissue specimens were evaluated using immunohistochemical technology. Western blotting, flow cytometry and quantitative real-time polymerase chain reaction (PCR) were used to detect protein expressions in HCC cell lines. ST2 expression was downregulated by utilizing the synthetic siRNA sequence that specifically targets ST2. The transfection of ST2 siRNAs and control siRNAs into HCC cells was performed with Lipofectamine RNAi MAX (Life Technologies) according to the manufacturer's protocol.ResultsOur results demonstrated that IL-33 is expressed both in cancer cells and stromal cells of the HCC microenvironment, and that IL-33 expression in cancer cells, but not in stromal cells, was negatively associated with survival of HCC patients. IL-33 promotes HCC stemness expansion, including upregulating core stem cell gene expression, inducing cell sphere formation and preventing chemotherapy-induced apoptosis in vitro. Mechanistically, IL-33 binds to its receptor ST2 and induces phosphorylation of c-Jun N-terminal kinase activation (JNK), which leads to HCC stemness expansion.ConclusionsIL-33/ST2 signaling might be potential prognosis markers and therapeutic targets for HCC patients.
       
  • Pseudo-Wellens’ Syndrome Temporally Associated with Immune Check
           Point Inhibitors Use
    • Abstract: Publication date: Available online 19 July 2019Source: The American Journal of the Medical SciencesAuthor(s): Mohamad Muhailan, Ghassan Al-Shbool
       
  • Dyspnea in Patients with Stiff-Person Syndrome
    • Abstract: Publication date: Available online 18 July 2019Source: The American Journal of the Medical SciencesAuthor(s): William Sexauer, Matthew Woodford, Katrina Pack, Anthony Allen, Albert Crawford, Goran RakocevicABSTRACTBackgroundStiff-person syndrome (SPS) is a rare autoimmune disorder that leads to progressively worsening stiffness and spasm of thoracic and proximal-limb musculature. Dyspnea has been reported but not analyzed in patients with SPS.MethodsFor this prospective study, 17 patients were recruited from a university-based neurology clinic. History and exam were performed, demographic information collected, available imaging reviewed. Dyspnea was assessed using vertical Visual Analog scales (VAS), the University of California San Diego Shortness of Breath Questionnaire (UCSD-SOBQ), and dyspnea “descriptors”. Standardized assessments of SPS severity were performed by an experienced neurologist. Forced vital capacity (FVC) spirometric analysis was performed on all patients.ResultsFifteen of 17 patients complained of dyspnea, including dyspnea at rest, with exertion, and disturbing sleep. A restrictive pattern was the most common abnormality noted on spirometry. FVC (r = -0.67; P < 0.01) and forced expiratory volume in 1-second (FEV1) (r = -0.76; P < 0.01) percent predicted correlated with dyspnea measured by VAS over the preceding 2 weeks. Pulmonary function did not correlate with UCSB-SOBQ or standardized measures of SPS severity.ConclusionsDyspnea in SPS is common and occurs at rest, with exertion, and disturbs sleep. The finding of restrictive physiology and correlation between pulmonary function variables and dyspnea support the hypothesis that thoracic cage constriction by rigidity and/or spasm of the muscles of the trunk causes or contributes to the sensation of dyspnea. The possibility of diaphragmatic involvement requires further study.
       
  • A Gaseous Kidney and Ureter
    • Abstract: Publication date: Available online 18 July 2019Source: The American Journal of the Medical SciencesAuthor(s): Po-Han Huang, Jyh-Tong Hsieh, Chih-Yu Yang
       
  • The value of plasma-based microRNAs as diagnostic biomarkers for ovarian
           cancer
    • Abstract: Publication date: Available online 17 July 2019Source: The American Journal of the Medical SciencesAuthor(s): Weiwei Wang, Yin Yin, Xia Shan, Xin Zhou, Ping Liu, Quan Cao, Danxia Zhu, JinYing Zhang, Wei Zhu BackgroundOvarian cancer (OC) is one of the most threatening diseases among women in the world. Plasma microRNAs (miRNAs) may serve as promising diagnostic biomarkers for patients with OC.MethodsUsing quantitative reverse transcription polymerase chain reaction (qRT-PCR) based on Exiqon panel, we identified 27 differentially expressed miRNAs from 2 OC pool samples and 1 normal control (NC) pool in the initial screening phase. Then we further validated the identified miRNAs through the training (32 OC VS. 34 NCs) and validation stages (69 OC VS. 66 NCs) using qRT-PCR. The expression levels of the miRNAs were also assessed in tissues and exosomes.ResultsFive plasma miRNAs (miR-205-5p, miR-145-5p, miR-10a-5p, miR-346, and miR-328-3p) were significantly overexpressed in OC in comparison with NCs. The areas under the receiver operating characteristic curve of the 5-miRNA panel were 0.788 for the training stage and 0.763 for the validation stage. The level of miR-205-5p has significantly different expression in patients with well–moderate histological grade compared with those with a poor grade (P = 0.012). The expression levels of the 5 miRNAs were also significantly upregulated in the exosomes of OC plasma samples (32 OC vs. 32 NCs). However, the expression of the 4 miRNAs (miR-145-5p, miR-10a-5p, miR-346, and miR-328-3p) was significantly lower in tumor samples than in normal tissues (22 OC vs. 22 NCs).ConclusionsThe 5 plasma miRNAs may be noninvasive diagnostic biomarkers of OC. The plasma miR-205-5p level may reflect the change trend of the histological grade of OC patients.
       
  • Continuous Glucose Monitoring: Review of an Innovation in Diabetes
           Management
    • Abstract: Publication date: Available online 17 July 2019Source: The American Journal of the Medical SciencesAuthor(s): Zainab Mian, Kathie L. Hermayer, Alicia Jenkins Most continuous glucose monitors (CGM) provide blood glucose trends with alarms and alerts to prevent hypoglycemia and provide better glycemic control. Continuous glucose monitors (CGM) used in conjunction with insulin pumps have changed the management of patients with insulin-dependent diabetes, mainly type 1 diabetes. CGM technology prevents the need for frequent blood glucose testing, which is often cumbersome for patients, providing them with a better alternative. CGM technology is under prescribed and therefore advantage should be taken of this technology to provide better A1C control and decrease incidence of diabetic complications. CGM is particularly useful in patients with hypoglycemia unawareness and nocturnal hypoglycemia. CGM is currently not approved in pregnant patients, in critically ill patients and patients on dialysis. Research suggests that the benefits certainly outweigh the limitations of this technology. This review article focuses on the technical and clinical use of continuous glucose monitoring and sensor-integrated pump technology.
       
  • Call a Spade a Spade: Missed Diagnosis of Apical Hypertrophic
           Cardiomyopathy
    • Abstract: Publication date: Available online 13 July 2019Source: The American Journal of the Medical SciencesAuthor(s): Davis Leaphart, Ashley Waring, Pal Suranyi, Valerian FernandesABSTRACTApical hypertrophic cardiomyopathy is a variant of hypertrophic cardiomyopathy characterized by apical hypertrophy, deep T-wave inversions in precordial electrocardiogram (EKG) leads, and a ventriculogram shaped like the ‘Ace of Spades’. Patients are often asymptomatic but sometimes present with atypical chest pain, angina, or atrial fibrillation. The deep T-wave inversions on EKG often mimic acute coronary syndrome. Coronary angiogram in these patients is unrevealing, but the characteristic left ventriculogram establishes this diagnosis. The deep T-wave inversions can appear suddenly or deepen over years, making the diagnosis difficult to establish early in the disease. Transthoracic echocardiogram may miss the hypertrophied apex, but echo contrast imaging or cardiac magnetic resonance imaging (MRI) can reliably confirm the diagnosis and detect apical aneurysms. We present a case of apical hypertrophic cardiomyopathy which was not evident despite many admissions, EKGs, cardiac catheterizations, and echocardiograms until the diagnosis was confirmed with left ventriculogram and cardiac MRI 20 years after initial presentation.
       
  • Gouty Tophi Manifesting as a Pancreatic Foci
    • Abstract: Publication date: Available online 13 July 2019Source: The American Journal of the Medical SciencesAuthor(s): Shreesh Shrestha, Faisal Kamal, Muhammad Ali Khan, Claudio R. Tombazzi Gout is a common disorder of uric acid metabolism highly prevalent in our population. The majority of the patients with gout present with acute monoarticular arthritis but, a significant proportion of patients also go on to develop chronic tophaceous gout. Musculoskeletal sites are the usual sites of tophus formation and, very rarely, tophi may form in a visceral organ. We present a case of pancreatic gout of which only 3 cases have been reported. Our case is unique and challenging, as it initially masqueraded a pancreatic neoplasm creating many diagnostic dilemmas.
       
  • Rofecoxib and Clinically Significant Gastrointestinal Events: Response
    • Abstract: Publication date: Available online 10 July 2019Source: The American Journal of the Medical SciencesAuthor(s): David Y. Graham, Nicholas P. Jewell, Francis K.L. Chan
       
  • Metformin Associated with Increased Survival in Type 2 Diabetes Patients
           with Pancreatic Cancer and Lymphoma
    • Abstract: Publication date: Available online 4 July 2019Source: The American Journal of the Medical SciencesAuthor(s): Anne Wynn, Albert Vacheron, Jeffrey Zuber, Solomon S. Solomon BackgroundThe biguanide drug metformin is one of the most commonly used medications for treatment of type 2 diabetes mellitus. Diabetics are at an increased risk for cancer. Previous studies have demonstrated improved outcomes in patients taking metformin suffering from prostate, colon, lung, thyroid, and esophageal cancers. Metformin's main anti-neoplastic mechanism of action is thought to be mediated through inhibition of mTOR, inhibition of HIF-1 Alpha, and activation of p53. We investigated the overall survival of type 2 diabetic patients on metformin with pancreatic cancer and lymphoma using the Computerized Patient Record System at the Veterans Affairs Medical Center, Memphis TN.MethodsLymphoma and pancreatic cancer patients with type 2 diabetes were sorted into an experimental (metformin) group and a control (non-metformin) group. Patients were compared on baseline characteristics including race, BMI, and age. Cancer outcomes including overall survival, metastasis, recurrences, and incidence of new malignancies were recorded. Hemoglobin A1C, creatinine, and cancer treatment modalities were recorded and compared. Statistical analyses used included unpaired t-tests and Chi-squared tests.ResultsThere was significantly greater overall long-term survival in the metformin group compared to the non-metformin group for lymphoma (5.89 vs 1.29 years, p
       
  • Association between Index of Nutritional Quality and Non-Alcoholic Fatty
           Liver Disease: The Role of vitamin D and B Group
    • Abstract: Publication date: Available online 1 July 2019Source: The American Journal of the Medical SciencesAuthor(s): Farhad Vahid, Azita Hekmatdoost, Sousan Mirmajidi, Saeid Doaei, Diyako Rahmani, Zeinab Faghfoori BackgroundNumerous studies have revealed that diet has been considered as an important pathogenic factor for non-alcoholic fatty liver disease (NAFLD). The Index of Nutritional Quality (INQ) is a method of quantitative and qualitative evaluation of single foods and diets, which has special significance in recognizing clinical nutritional problems.MethodsThis study included 295 patients with NAFLD and 704 controls. The dietary intake was assessed through a valid and reliable food frequency questionnaire. INQ was calculated from the questionnaire data and was compared between the 2 groups.ResultsThe controls had higher INQ of vitamin D, vitamin E, thiamin, riboflavin, niacin, vitamin B12; biotin, pantothenic acid, magnesium, and zinc compared to the patients with NAFLD. After controlling for several covariates, positive associations were observed between NAFLD risk and INQs of riboflavin (ORriboflavin = 0.49, 95% CI: 0.28-0.78, ORbiotin = 0.35, 95% CI: 0.18-0.76, ORpantothenic = 0.28, 95% CI: 0.12-0.64, ORmagnesium = 0.28, 95% CI: 0.11-0.75, ORzinc = 0.15 95% CI: 0.05-0.42).ConclusionsFindings of the present study suggest that subjects who follow a more healthy and nutrient-rich diet, especially in terms of vitamins D, B1, B2, B12, B3, and zinc, are at a lower risk of NAFLD compared to those who consume unhealthy and nutrient-poor diet.
       
  • Optimal blood pressure in patients with coronary artery disease and
           chronic kidney disease: HIJ-CREATE substudy
    • Abstract: Publication date: Available online 29 June 2019Source: The American Journal of the Medical SciencesAuthor(s): Kazuki Tanaka, Kentaro Jujo, Junichi Yamaguchi, Hiroshi Ogawa, Nobuhisa HagiwaraABSTRACTBackgroundLowering blood pressure (BP) is important in improving the prognosis of hypertensive patients with coronary artery disease (CAD). Patients suffering CAD with chronic kidney disease (CKD) have poorer prognosis than those without CKD. However, there is limited evidence regarding the benefit of BP-lowering therapy on cardiovascular outcomes in patients with CAD and CKD. In this study, we aimed to evaluate the relation between major adverse cardiac events (MACE) and achieved BP in hypertensive patients with CAD and CKD as a high-risk population.MethodsThis study was a post hoc analysis from the HIJ-CREATE trial, a multicenter, prospective, randomized controlled study comparing the effects of antihypertensive therapy with and without candesartan on MACE in 2049 hypertensive patients with angiographically documented CAD. Of these, 1002 patients had CKD with a diagnosis of estimated glomerular filtration rate (eGFR)
       
  • A Rare Case of Bronchopulmonary Sequestration Masquerading as Lung Abscess
    • Abstract: Publication date: Available online 29 June 2019Source: The American Journal of the Medical SciencesAuthor(s): Abdulmonam Ali, Yousef Abdel-Aziz, Youngsook Yoon
       
  • Benign Mediastinal Ectopic Thyroid Mass: An Incidental Finding
    • Abstract: Publication date: Available online 27 June 2019Source: The American Journal of the Medical SciencesAuthor(s): Ankit Agrawal, Kesavan Sankaramangalam, Talha E. Khan, Divyajot Sadana
       
  • Impact of stable coronary artery disease on the efficacy of cryoballoon
           ablation for the atrial fibrillation
    • Abstract: Publication date: Available online 21 June 2019Source: The American Journal of the Medical SciencesAuthor(s): Lu Liu, Dongdong Zhao, Jun Zhang, Haotian Yang, Fuad A. Abdu, Rong Guo, Shuang Li, Kai Tang, Hailing Li, Wenliang Che, Yawei Xu BackgroundCryoballoon ablation has become an effective strategy for the treatment of atrial fibrillation (AF) without coronary artery disease (CAD). AF is usually coupled with CAD. However, the impact of CAD on the outcome of cryoablation in AF patients remains unclear. The objective of our study was to investigate the impact of stable CAD on the efficacy of cryoballoon ablation for AF.MethodsThe data of 384 patients who underwent AF cryoablation were consecutively collected. Patients were classified into a CAD group and a non-CAD group. All patients were listed for a scheduled follow-up visit in the outpatient clinics to evaluate the AF recurrence at 1, 3, 6, and 12 months after cryoablation.ResultsSeventy-four patients (19.3%) suffered from stable CAD, and 31 (8.1%) of them underwent PCI before cryoablation. Cryoablation was performed in 1521 pulmonary veins and 99.1% of pulmonary vein isolation was achieved. Successful follow-up was obtained in 354 patients after a mean of 12 ± 6 months, in which 280 patients (79.1%) had maintained stable sinus rhythm, and 74 patients (20.9%) had AF recurrence. There was no significant difference in AF recurrence between patients with and without CAD (16.4% vs. 22.0%). Furthermore, the presence, location and severity of CAD were not associated with AF recurrence after cryoablation while persistent AF, N-terminal pro-brain natriuretic peptide and left atrial diameter served as independent predictors of AF recurrence.ConclusionsCryoballoon ablation is effective for the treatment of AF in stable CAD patients. The presence of CAD has no impact on the AF recurrence after cryoablation.
       
  • Evolving field of long-term antithrombotic therapy after percutaneous
           coronary intervention in patients with atrial fibrillation
    • Abstract: Publication date: Available online 15 June 2019Source: The American Journal of the Medical SciencesAuthor(s): Tuomas Kiviniemi
       
  • DRESS Syndrome and Chronic Renal Failure Induced by Ethambutol
    • Abstract: Publication date: Available online 12 June 2019Source: The American Journal of the Medical SciencesAuthor(s): El Ghoul Jamel, Sghaier Ahmed
       
  • Utility of Routine Blood Cultures for Inpatient Hematology/Oncology
           Patients Receiving Antimicrobials
    • Abstract: Publication date: Available online 8 June 2019Source: The American Journal of the Medical SciencesAuthor(s): Leonard C. Alsfeld, Don C. Rockey BackgroundBlood cultures are drawn regularly on hematology/oncology patients due to the concern for infectious complications. However, this practice is costly in many ways, and there are limited data to support this practice. We aimed to investigate the frequency with which blood cultures are drawn in these patients, and moreover, how frequently they provide meaningful data.MethodsWe performed a single-center retrospective review study in hematology/oncology patients admitted to our hospital. We reviewed 1,437 blood cultures from 220 unique patients between July 1, 2013 and June 30, 2014. We reviewed the proportion and characteristics of the positive blood cultures, as well as organisms isolated.ResultsOf all 1,437 blood cultures drawn during the study period, 111 (8%) of the blood cultures grew a clinically meaningful organism. Gram-positive organisms were more likely than gram-negative organisms, with coagulase-negative Staphylococcus and vancomycin-resistant Enterococcus (VRE) being most common. In patients who were receiving broad-spectrum antimicrobials, only 13 (4%) of 358 blood cultures collected grew a clinically meaningful organism, all of which were performed for clearance. None of these 13 positive blood cultures represented a new infectious organism. No patient receiving broad-spectrum antibiotics with blood cultures drawn in response to a fever had a positive culture.ConclusionsIn hospitalized cancer patients receiving broad-spectrum antimicrobials, the likelihood of growing a new clinically significant organism from a blood culture was extremely low. We speculate that the practice of repeating blood cultures in hospitalized cancer patients on broad-spectrum antimicrobials, particularly in response to fever alone, should be eliminated.
       
  • c-Myc overexpression promotes oral cancer cell proliferation and migration
           by enhancing glutaminase and glutamine synthetase activity
    • Abstract: Publication date: Available online 7 June 2019Source: The American Journal of the Medical SciencesAuthor(s): Tao Wang, Bolei Cai, Mingchao Ding, Zhongping Su, Yanpu Liu, Liangliang Shen BackgroundThis study aimed to investigate whether glutaminase (GLS) and glutamine synthetase (GS) are involved in c-Myc-mediated tumor development in oral cancer.MethodsThe correlation between the expressions of c-Myc, GLS, and GS in clinical samples and the clinicopathologic features of oral cancer were examined using immunohistochemistry and quantitative real-time polymerase chain reaction. After overexpressing the c-Myc gene and using an inhibitor of GLS or GS, functional experiments were performed to confirm the effects of c-Myc, GLS, and GS on proliferation, cell cycle, and migration in KB oral cancer cells. The expressions of E-cadherin and N-cadherin were determined by immunofluorescence assays in KB cells overexpressing c-Myc in the presence of GLS or GS inhibitors.ResultsThe protein expression of GS was correlated with the TNM stage. In addition, c-Myc mRNA levels were positively correlated with GS mRNA levels. Overexpression of c-Myc increased the colonies derived from oral cancer cells and caused more cells to be in S phase compared with the mock-vehicle group. The migratory speed of KB cells was promoted by overexpression of c-Myc compared to the mock-vehicle group. However, these effects were effectively reversed in the presence of GLS or GS inhibitor. Furthermore, c-Myc could inhibit E-cadherin protein expression while promoting N-cadherin expression by enhancing the activity of GLS and GS.Conclusionsc-Myc overexpression promotes oral cancer cell proliferation and migration by enhancing GLS and GS activity. Our findings are beneficial for the identification of novel molecular targets for the prevention and treatment of oral cancer.
       
  • BLOOD CULTURES & CULTURE CHANGE
    • Abstract: Publication date: Available online 7 June 2019Source: The American Journal of the Medical SciencesAuthor(s): Stacey W. McKenzie, Robert T. Means
       
  • Erratum: Correction of corresponding author
    • Abstract: Publication date: Available online 6 June 2019Source: The American Journal of the Medical SciencesAuthor(s): Yun-Hua Kuo, Tze-Fang Wang, Li-Kuo Liu, Wei-Ju Lee, Li-Ning Peng, Liang-Kung Chen
       
  • Inhibiting Mnk selectively targets cervical cancer via suppressing
           eIF4E-mediated β-catenin activation
    • Abstract: Publication date: Available online 5 June 2019Source: The American Journal of the Medical SciencesAuthor(s): Weijia Zhang, Xiaoyan Su, Shuang Li, Ya Wang, Qian Wang, Hai ZengABSTRACTBackgroundTargeting β-catenin has been shown to have great potential therapeutic value in cervical cancer. Because β-catenin is also essential for normal cells, strategies to specifically target cancer will require identification of druggable factors capable of distinguishing β-catenin signaling pathways between cancer and normal cells.MethodsExpression of p-eIF4E and p-β-catenin was analyzed in malignant and normal cervical tissues and cells. The effects and its underlying mechanisms of targeting MNK and eIF4E were determined in cervical cancer and normal cells.ResultsInhibiting MNK/eIF4E axis selectively targets cervical cancer without affecting normal cervical cells, via suppressing eIF4E-mediated β-catenin activation. We found that eIF4E phosphorylation was upregulated in cervical cancer cells and tissues but not normal cervical counterparts, and its phosphorylation at Ser 209 activates Wnt/β-catenin signaling, promotes growth and migration in cervical cancer, in a MNK-dependent manner. MNK inhibition via genetic small interfering RNA (siRNA) knockdown or pharmacological inhibitor effectively decreased phosphorylation of eIF4E and β-catenin, leading to reduced β-catenin activity and transcript levels of Wnt target genes in cervical cancer cells. Consistently, we found that MNK kinase inhibitor is effective in inhibiting proliferation and migration, and inducing apoptosis in cervical cancer but not normal cervical cells. The combination of MNK kinase inhibitor with paclitaxel achieved greater efficacy in cervical cancer cells than paclitaxel alone.ConclusionsOur work identifies MNK-eIF4E axis as a specific and critical regulator of β-catenin activity in cervical cancer but not normal cervical cells, and suggests that targeting MNK is a useful therapeutic strategy in cervical cancer.
       
  • The temperature in the Hospitalized Patient
    • Abstract: Publication date: Available online 1 June 2019Source: The American Journal of the Medical SciencesAuthor(s): Ivayla I. Geneva, Brian Cuzzo, Tasaduq Fazili, Waleed Javaid BACKGROUNDHuman body temperature is believed to be linked to clinical diagnoses. However, most of the available data stems from healthy individuals, with no large-scale studies addressing body temperature in the inpatient setting, which is the focus of our study.METHODSThis is a retrospective analysis of a total of 695,107 temperature readings from 16,245 patients hospitalized over a 1-year period at a tertiary medical center, ages 0 to 105 years, 50% female, with rectal, monotherm, axillary, oral, temporal, and tympanic measurement sites. The average temperature (Tave) per patient and per measurement site was used in all calculations. Descriptive statistics, Student's T-test, and Pearson's correlation were used, where appropriate, with statistical significance set at P < 0.05.RESULTSTave from all measurement sites was 98.13+/-0.48(SD)F(36.74+/-0.27C). Tave varied by the site of measurement, in decreasing order highest-to-lowest being rectal, monotherm, axillary, oral, temporal, and tympanic, all of which were higher than the available reported averages for healthy subjects. Tave decreased as patients’ age increased. There was only slight and likely clinically insignificant difference between the genders. There were differences in Tave between the Intensive Care Units (ICUs), listed from highest-to-lowest: Neuro ICU, Pediatric ICU, Surgical ICU, Cardiac ICU, and Medical ICU. However, there was no difference between all ICU and non-ICU patients.CONCLUSIONSOur inpatient data demonstrates that previously identified body temperature trends among healthy subjects are preserved, to an extent, in the inpatient setting. To our knowledge, ours is the first study that evaluates the temperatures of all hospitalized patients at a large tertiary medical center.
       
  • Predicting outcomes in sepsis
    • Abstract: Publication date: Available online 31 May 2019Source: The American Journal of the Medical SciencesAuthor(s): John D. Price, Rodrigo Cavallazzi
       
  • Notice of Overlapping Publication: Priority for Treatment and Intensive
           Care of Patients With Non-Severe Community-Acquired Pneumonia” (Li et
           al. Am J Med Sci, 2018, 356(4):329)
    • Abstract: Publication date: Available online 28 May 2019Source: The American Journal of the Medical SciencesAuthor(s):
       
  • Magnetic Resonance Imaging Findings of Intrapulmonary Hematoma
    • Abstract: Publication date: Available online 25 May 2019Source: The American Journal of the Medical SciencesAuthor(s): Hiroshi Wada, Takuto Sakashita, Akitoshi Inoue
       
  • Systemic Lupus Erythematosus and Vitamin D: Should we recommend that our
           patients take supplements'
    • Abstract: Publication date: Available online 25 May 2019Source: The American Journal of the Medical SciencesAuthor(s): Winters Stephen J.
       
  • Late PCI in patients with ST-segment elevation myocardial infarction with
           prolonged ischemic symptoms beyond the 12 hour window: The importance of
           knowing the presence of multi-vessel coronary artery disease
    • Abstract: Publication date: Available online 23 May 2019Source: The American Journal of the Medical SciencesAuthor(s): Osmar Antonio Centurión
       
  • Trends in Out-of-Pocket Burden in United States Adults with Kidney
           Disease: 2002 – 2011
    • Abstract: Publication date: Available online 23 May 2019Source: The American Journal of the Medical SciencesAuthor(s): Mukoso N Ozieh, Kinfe G Bishu, Clara E Dismuke, Leonard E EgedeABSTRACTBackgroundHigh out-of-pocket (OOP) costs is a barrier to health care access and treatment compliance. Our study examined high OOP health care cost and burden trends in adults with kidney disease.MethodsUsing Medical Expenditure Survey 2002-2011 data, we examined the proportion of people greater than 17 years old with kidney disease whose OOP burden were high. Trends by insurance status i.e. private, public or none and trends by income level i.e. poor, low, middle or high income were also examined in this study.ResultsApproximately 16% of people with kidney disease faced high OOP burden in 2011. The proportion of adults with high OOP burden between 2002 and 2011 fell by 9.7% points. The proportion of privately insured adults facing high OOP burden decreased by 4.7, those who were publicly insured 22.4, and those who were uninsured, 3.1 percentage points. The proportion of those facing high OOP burden who were poor/near poor fell by 26.5, those who had low income 13.4, and those who had middle income, 9 percentage points.ConclusionsThough high OOP burden declined between 2002 and 2011 in the US population with kidney disease, most of the decline was among the publicly insured, so that the uninsured populations with kidney disease remain vulnerable. Providers and policy makers should be aware of the vulnerability of uninsured individuals with kidney disease to high OOP burden.
       
  • Primary Diffuse Large B-Cell Lymphoma of the Descending Colon
    • Abstract: Publication date: Available online 23 May 2019Source: The American Journal of the Medical SciencesAuthor(s): Bashar Sharma, Natalie Pavelock, Marsha Antoine, Mili Shah, Kristyn Galbraith, Sekou Rawlins Primary non-Hodgkin lymphoma of the gastrointestinal tract is rare with an incidence of 10-15% of all non-Hodgkin lymphoma cases and 1-4% of all gastrointestinal tumors. The most common sites of involvement include the stomach, small intestines, colon and rectum. Primary colorectal lymphoma is extremely rare representing only 0.2 – 0.6% of all colorectal malignancies. The presentation is usually non-specific leading to delay in diagnosis. Imaging is used to locate the tumor and its extension. Colonoscopy usually shows a fungating mass, infiltrative or ulcerative lesions. Diffuse large B-cell lymphoma is the most common histological subtype. Management of diffuse large B-cell lymphoma usually involves chemotherapy, radiation, surgery or a combination approach.
       
  • Association Between Time to Defibrillation and Neurological Outcome in
           Patients With In-hospital Cardiac Arrest
    • Abstract: Publication date: Available online 21 May 2019Source: The American Journal of the Medical SciencesAuthor(s): Jin-Young Kang, Youn-Jung Kim, Yu Jung Shin, Jin Won Huh, Sang Bum Hong, Won Young Kim BackgroundThe influence of time to defibrillation in patients with shockable in-hospital cardiac arrest (IHCA) has not been fully assessed. This study investigated the association between time to defibrillation and neurological outcome in shockable IHCA survivors.MethodsA 7-year retrospective cohort study was conducted using a prospectively collected registry of adult IHCA patients. Patients whose first documented rhythm was pulseless ventricular tachycardia or ventricular fibrillation and who received defibrillation within 5 minutes were included.ResultsAmong 1683 IHCA patients, 261 patients were included. At 28 days, a good neurological outcome (Cerebral Performance Category score 1 or 2) according to time to defibrillation was seen in 49.0%, 21.1%, 13.4% and 16.5% of patients treated at
       
  • Pyogenic liver abscess, empyema, and splenic abscess
    • Abstract: Publication date: Available online 21 May 2019Source: The American Journal of the Medical SciencesAuthor(s): Shih-Wei Lai
       
  • Delayed respiratory distress in a patient with chronic obstructive
           pulmonary disease after abdominal surgery
    • Abstract: Publication date: Available online 7 May 2019Source: The American Journal of the Medical SciencesAuthor(s): Angelo Riccione, Kenneth Nugent Patients with chronic obstructive pulmonary disease (COPD) are at increased risk for perioperative complications. The frequency of complications depends on the severity of COPD, the type of anesthesia used, the surgical site, and other comorbidities. Patients undergoing upper abdominal surgery have significant changes in lung volumes, likely secondary to changes in diaphragm function and abdominal pain, and these changes increase the risk for complications, including acute respiratory failure, atelectasis, pneumonia, and unplanned reintubation. We discuss a patient with COPD who did well for the first 3 days following an open incisional hernia repair. However, on the fourth day he noted significant dyspnea and radiographic studies revealed atelectasis. Over the next week the patient remained symptomatic and dependent on noninvasive ventilation; he eventually had a rapid response to corticosteroids. This case indicates that atelectasis can develop late following a surgical procedure and that multiple factors potentially influence development of this complication.
       
  • Penetrating Aortic Ulcer Masquerading as Acute Coronary Syndrome
    • Abstract: Publication date: Available online 7 May 2019Source: The American Journal of the Medical SciencesAuthor(s): Ajay Kumar Mishra, Srinivas Nadadur, Kamal Kant Sahu, Amos Lal
       
  • Treatment windows and clinical outcomes in late-presenting patients with
           ST-segment elevation myocardial infarction
    • Abstract: Publication date: Available online 7 May 2019Source: The American Journal of the Medical SciencesAuthor(s): Ming Gao, Ling Qin, Zhiguo Zhang, Liping Chen, Yang Zheng, Qian Tong, Quan Liu BackgroundPercutaneous coronary intervention (PCI) is the reperfusion strategy typically used in patients with ST-segment elevation myocardial infarction (STEMI) who present with prolonged ischemic symptoms (>12 hours after onset). However, there is no consensus on an optimal time window for PCI. We examined a real-world cohort, assessing time from symptom onset to balloon inflation in relation to long-term nonfatal recurrent myocardial infarction (MI) or all-cause mortality.MethodsA total of 825 consecutive patients presenting with ischemic symptoms of STEMI>12 hours after symptom onset and undergoing subsequent primary PCI were grouped by time-to-treatment status (≤7 days or>7 days post-MI). Primary endpoints were nonfatal recurrent MI and all-cause mortality.ResultsCumulative rates of recurrent nonfatal MI at 2 years were 4.1% and 3.3% in patients with symptom-onset-to-balloon inflation times of ≤7 days and>7 days, respectively (P = 0.049); and corresponding mortality rates were 3.4% and 4.7% (P = 0.238). In Cox multivariate analyses, syndrome-onset-to-balloon-inflation time was not independently predictive of recurrent MI (P = 0.052) or mortality (P = 0.651) at 2 years, once adjusted for certain clinical and angiographic variables known to influence patient outcomes. The 2-year rate of recurrent MI was highest in patients with multi-vessel coronary artery diseases undergoing primary PCI ≤7 days after symptom onset to balloon inflation (P = 0.005).ConclusionsIn patients presenting with ischemic signs or symptoms of STEMI>12 hours after initial symptom onset and treated by PCI, symptom-onset-to-balloon-inflation times ≤7 days showed no relation to nonfatal recurrent MI, unless in the presence of multi-vessel coronary artery diseases.
       
  • “Fournier's Gangrene Following Piquerism”
    • Abstract: Publication date: Available online 26 April 2019Source: The American Journal of the Medical SciencesAuthor(s): Padmastuti Akella, Ajay Kumar Mishra, Himmat Grewal
       
  • Efficacy and safety of vitamin D supplementation in patients with systemic
           lupus erythematosus: A meta-analysis of randomized controlled trials
    • Abstract: Publication date: Available online 26 April 2019Source: The American Journal of the Medical SciencesAuthor(s): Ronghao Zheng, Alex Gonzalez, Jing Yue, Xiaolin Wu, Ming Qiu, Lin Gui, Songbai Zhu, Li Huang BackgroundThe efficacy of vitamin D supplementation in patients with systemic lupus erythematosus (SLE) remains uncertain. This meta-analysis aimed to systematically evaluate the efficacy and safety of vitamin D supplementation in patients with SLE.MethodsRandomized controlled trials (RCTs) were searched in PubMed, Embase, Cochrane CENTRAL, and Web of Science databases. The retrieved studies were subjected to meta-analysis using the fixed-effect or random-effect model.ResultsFive eligible RCTs enrolling 490 participants were included. Compared to the placebo treatment, vitamin D supplementation significantly increased the level of serum 25-hydroxyvitamin D (25(OH)D) (5 trials, 490 participants: standard mean difference (SMD) = 2.072, 95% CI: 1.078–3.066, P < 0.001). The pooled result from 2 RCTs showed that vitamin D supplementation decreased the fatigue severity scale scores in patients with SLE (2 trials, 79 participants: SMD = -1.179, 95% CI: -1.897 to -0.460, P = 0.001). The SLE disease activity index scores and positivity of anti-double-stranded DNA antibodies (anti-dsDNA) did not differ significantly (4 trials, 223 participants: SMD = -0.507, 95% CI: -1.055–0.041, P = 0.070; Three trials, 361 participants: Risk ratio=0.880, 95% CI: 0.734–1.054, P=0.165) between the vitamin D supplementation group and the placebo treatment group. None of the included studies reported severe adverse events associated with vitamin D supplementation.ConclusionsThis meta-analysis suggested that vitamin D supplementation is effective in increasing the serum 25(OH)D levels, may improve fatigue, and is well-tolerated in patients with SLE, however, it does not seem to have significant effects in decreasing the positivity of anti-dsDNA and disease activity.
       
  • Janeway Lesion in a Uremic Woman
    • Abstract: Publication date: Available online 25 April 2019Source: The American Journal of the Medical SciencesAuthor(s): Shum-Shin Lin, Yu-Jang Su
       
  • Laboratory discrimination between neutrophilic malignant and parapneumonic
           pleural effusions
    • Abstract: Publication date: Available online 19 April 2019Source: The American Journal of the Medical SciencesAuthor(s): Jaehee Lee, Yong Hoon Lee, Hyewon Seo, Hyunchul Lee, Yu Kyung Kim, Seung Soo Yoo, Shin Yup Lee, Seung Ick Cha, Jae Yong Park, Chang Ho Kim BackgroundMalignant pleural effusion (MPE) occasionally demonstrates neutrophilic predominance, commonly found in parapneumonic pleural effusion (PPE). In comparison with lymphocytic MPE, neutrophilic MPE may have different characteristics associated with a more intense inflammatory response and poor prognosis. These characteristics of neutrophilic MPE may lead to inappropriate management and delayed diagnosis. Moreover, the limited diagnostic yield of microbiological and cytological tests makes early differential diagnosis between neutrophilic MPE and PPE more challenging. This study investigated objective laboratory findings to help distinguish neutrophilic MPE from PPE.MethodsA retrospective study was conducted on patients with neutrophilic MPE and PPE. Routine blood and pleural fluid data of the 2 groups were compared, and the diagnostic performances of predictors for neutrophilic MPE were assessed using receiver-operating characteristic curves.ResultsForty-one and 140 patients with neutrophilic MPE and PPE, respectively, were included. In final analysis, serum C-reactive protein (S-CRP), pleural fluid neutrophil-to-lymphocyte ratio (NLR), and pleural fluid carcinoembryonic antigen (CEA) were significantly different between the 2 groups. With cut-off values of S-CRP
       
  • Ethnicity and Diabetic Quality-of-Life
    • Abstract: Publication date: Available online 19 April 2019Source: The American Journal of the Medical SciencesAuthor(s): Gary C. Brown, Melissa M. Brown, Sanjay Sharma BackgroundMultiple studies have addressed ethnic diabetes mellitus (diabetes) care inequalities. But few have assessed whether ethnicity influences patient perceptions of diabetic quality-of-life (QOL). The authors therefore designed a cross-sectional study to quantify the overall QOL associated with diabetes in consecutive white (Caucasian) and black (African-American) participants.MethodsA validated, time tradeoff utility instrument was consecutively administered by interview to 518 white and 92 African-American, adult, diabetic participants in an ambulatory setting. The instrument calculates QOL by quantifying a utility associated with their condition, with utility anchors of 1.00 (perfect health for that condition permanently) and 0.00 (death). Utility acquisition as used herein, first requires asking participants to estimate their theoretical remaining time of life, then subtracting from 1.00 the maximum proportion of their estimated remaining time of life they would be willing to hypothetically trade—if any—to permanently cure their condition (diabetes). Thus, a diabetic participant estimating 20 remaining years of life who will theoretically trade three of those years to cure their diabetes, has a diabetes-associated utility of [1.00 – (3/20) =)] 0.85. The closer the utility is to 1.00, the better the QOL associated with a condition, while the closer it is to 0.00, the poorer the associated QOL.ResultsThe mean diabetes utility (QOL) for the white, diabetic participant cohort was 0.87, while that for the black cohort was 0.86 (p=0.95). The ethnic cohorts were matched for age (p=0.70), gender (p=0.64), level of education (p=0.29), known years of having diabetes (p=0.10), insulin use (p=0.23), type of diabetes (p=0.27) and the number of associated comorbidities (p=0.23). There was no difference between the cohorts for the presence and severity of the individual, diabetes-related comorbidities of retinopathy (p=0.15), nephropathy (p=0.24), neuropathy (p=0.52), depression (p=0.23), and heart disease (p=0.32). Multiple linear regression integrating both cohorts revealed no effect of ethnicity upon diabetes utility (p=0.60).ConclusionsDiabetes-related QOL was similar in matched cohorts of adult white and black participants with diabetes mellitus. This study suggests utilities for diabetes mellitus can be used in economic analyses without adjustment for white and black ethnicity.
       
  • Man with tarry stool
    • Abstract: Publication date: Available online 19 April 2019Source: The American Journal of the Medical SciencesAuthor(s): ZhouPeng Wu, Yukui Ma
       
  • Is oral health maintenance/promotion crucial in patients treated with the
           Left Ventricular Assist Device'
    • Abstract: Publication date: Available online 10 April 2019Source: The American Journal of the Medical SciencesAuthor(s): Fawad Javed, Dimitrios Michelogiannakis
       
  • Alternative Explanation for Spread of Klebsiella pneumoniae Infection from
           Pyogenic Liver Abscess into Thorax
    • Abstract: Publication date: Available online 6 April 2019Source: The American Journal of the Medical SciencesAuthor(s): Jim Q. Ho, Ware G. Kuschner
       
  • Gastric Mucosa Diffuse Swelling in a Rare Case: Signet-ring Cell Carcinoma
    • Abstract: Publication date: Available online 2 April 2019Source: The American Journal of the Medical SciencesAuthor(s): Wei Sen Zhang, Qi Liu, Lin Zhang
       
 
 
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