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  Subjects -> MEDICAL SCIENCES (Total: 8279 journals)
    - ALLERGOLOGY AND IMMUNOLOGY (208 journals)
    - ANAESTHESIOLOGY (117 journals)
    - CARDIOVASCULAR DISEASES (327 journals)
    - CHIROPRACTIC, HOMEOPATHY, OSTEOPATHY (21 journals)
    - COMMUNICABLE DISEASES, EPIDEMIOLOGY (222 journals)
    - DENTISTRY (284 journals)
    - DERMATOLOGY AND VENEREOLOGY (161 journals)
    - EMERGENCY AND INTENSIVE CRITICAL CARE (119 journals)
    - ENDOCRINOLOGY (147 journals)
    - FORENSIC SCIENCES (41 journals)
    - GASTROENTEROLOGY AND HEPATOLOGY (181 journals)
    - GERONTOLOGY AND GERIATRICS (131 journals)
    - HEMATOLOGY (151 journals)
    - HYPNOSIS (4 journals)
    - INTERNAL MEDICINE (164 journals)
    - LABORATORY AND EXPERIMENTAL MEDICINE (97 journals)
    - MEDICAL GENETICS (58 journals)
    - MEDICAL SCIENCES (2235 journals)
    - NURSES AND NURSING (353 journals)
    - OBSTETRICS AND GYNECOLOGY (198 journals)
    - ONCOLOGY (373 journals)
    - OPHTHALMOLOGY AND OPTOMETRY (134 journals)
    - ORTHOPEDICS AND TRAUMATOLOGY (163 journals)
    - OTORHINOLARYNGOLOGY (80 journals)
    - PATHOLOGY (96 journals)
    - PEDIATRICS (269 journals)
    - PHYSICAL MEDICINE AND REHABILITATION (152 journals)
    - PSYCHIATRY AND NEUROLOGY (809 journals)
    - RADIOLOGY AND NUCLEAR MEDICINE (190 journals)
    - RESPIRATORY DISEASES (103 journals)
    - RHEUMATOLOGY (75 journals)
    - SPORTS MEDICINE (78 journals)
    - SURGERY (389 journals)
    - UROLOGY, NEPHROLOGY AND ANDROLOGY (149 journals)

MEDICAL SCIENCES (2235 journals)                  1 2 3 4 5 6 7 8 | Last

Showing 1 - 200 of 3562 Journals sorted alphabetically
16 de Abril     Open Access   (Followers: 1)
3D Printing in Medicine     Open Access   (Followers: 4)
4 open     Open Access  
AADE in Practice     Hybrid Journal   (Followers: 6)
ABCS Health Sciences     Open Access   (Followers: 7)
Abia State University Medical Students' Association Journal     Full-text available via subscription   (Followers: 2)
AboutOpen     Open Access  
ACIMED     Open Access   (Followers: 1)
ACS Medicinal Chemistry Letters     Hybrid Journal   (Followers: 46)
Acta Bio Medica     Full-text available via subscription   (Followers: 2)
Acta Bioethica     Open Access  
Acta Bioquimica Clinica Latinoamericana     Open Access   (Followers: 1)
Acta Científica Estudiantil     Open Access  
Acta Facultatis Medicae Naissensis     Open Access  
Acta Herediana     Open Access  
Acta Informatica Medica     Open Access  
Acta Medica (Hradec Králové)     Open Access  
Acta Medica Bulgarica     Open Access  
Acta Medica Colombiana     Open Access   (Followers: 1)
Acta Médica Costarricense     Open Access   (Followers: 2)
Acta Medica Indonesiana     Open Access  
Acta Medica International     Open Access  
Acta medica Lituanica     Open Access  
Acta Medica Marisiensis     Open Access  
Acta Medica Martiniana     Open Access  
Acta Medica Nagasakiensia     Open Access   (Followers: 1)
Acta Medica Peruana     Open Access   (Followers: 2)
Acta Médica Portuguesa     Open Access  
Acta Medica Saliniana     Open Access  
Acta Scientiarum. Health Sciences     Open Access   (Followers: 2)
Acupuncture & Electro-Therapeutics Research     Full-text available via subscription   (Followers: 6)
Acupuncture and Natural Medicine     Open Access  
Addiction Science & Clinical Practice     Open Access   (Followers: 8)
Addictive Behaviors Reports     Open Access   (Followers: 9)
Adıyaman Üniversitesi Sağlık Bilimleri Dergisi / Health Sciences Journal of Adıyaman University     Open Access   (Followers: 1)
Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi     Open Access  
Advanced Biomedical Research     Open Access  
Advanced Health Care Technologies     Open Access   (Followers: 8)
Advanced Science, Engineering and Medicine     Partially Free   (Followers: 8)
Advanced Therapeutics     Hybrid Journal  
Advances in Bioscience and Clinical Medicine     Open Access   (Followers: 7)
Advances in Cell and Gene Therapy     Hybrid Journal  
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 26)
Advances in Life Course Research     Hybrid Journal   (Followers: 9)
Advances in Lipobiology     Full-text available via subscription   (Followers: 1)
Advances in Medical Education and Practice     Open Access   (Followers: 32)
Advances in Medical Ethics     Open Access   (Followers: 1)
Advances in Medical Research     Open Access   (Followers: 1)
Advances in Medical Sciences     Hybrid Journal   (Followers: 9)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 6)
Advances in Medicine     Open Access   (Followers: 3)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 5)
Advances in Molecular Oncology     Open Access   (Followers: 2)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 7)
Advances in Parkinson's Disease     Open Access  
Advances in Phytomedicine     Full-text available via subscription  
Advances in Preventive Medicine     Open Access   (Followers: 6)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 20)
Advances in Regenerative Medicine     Open Access   (Followers: 3)
Advances in Skeletal Muscle Function Assessment     Open Access  
Advances in Therapy     Hybrid Journal   (Followers: 5)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 15)
Advances in Virus Research     Full-text available via subscription   (Followers: 6)
Advances in Wound Care     Hybrid Journal   (Followers: 12)
Aerospace Medicine and Human Performance     Full-text available via subscription   (Followers: 13)
African Health Sciences     Open Access   (Followers: 3)
African Journal of Biomedical Research     Open Access   (Followers: 1)
African Journal of Clinical and Experimental Microbiology     Open Access   (Followers: 4)
African Journal of Laboratory Medicine     Open Access   (Followers: 2)
African Journal of Medical and Health Sciences     Open Access   (Followers: 3)
African Journal of Thoracic and Critical Care Medicine     Open Access  
African Journal of Trauma     Open Access   (Followers: 1)
Afrimedic Journal     Open Access   (Followers: 2)
Aggiornamenti CIO     Hybrid Journal   (Followers: 1)
AIDS Research and Human Retroviruses     Hybrid Journal   (Followers: 9)
AJOB Empirical Bioethics     Hybrid Journal   (Followers: 3)
AJSP: Reviews & Reports     Hybrid Journal  
Aktuelle Ernährungsmedizin     Hybrid Journal   (Followers: 4)
Al-Azhar Assiut Medical Journal     Open Access   (Followers: 2)
ALERTA : Revista Científica del Instituto Nacional de Salud     Open Access  
Alexandria Journal of Medicine     Open Access   (Followers: 1)
Allgemeine Homöopathische Zeitung     Hybrid Journal   (Followers: 3)
Alpha Omegan     Full-text available via subscription  
ALTEX : Alternatives to Animal Experimentation     Open Access   (Followers: 2)
Althea Medical Journal     Open Access   (Followers: 2)
American Journal of Biomedical Engineering     Open Access   (Followers: 15)
American Journal of Biomedical Research     Open Access   (Followers: 2)
American Journal of Biomedicine     Full-text available via subscription   (Followers: 7)
American Journal of Chinese Medicine, The     Hybrid Journal   (Followers: 4)
American Journal of Clinical Medicine Research     Open Access   (Followers: 8)
American Journal of Family Therapy     Hybrid Journal   (Followers: 10)
American Journal of Law & Medicine     Full-text available via subscription   (Followers: 11)
American Journal of Lifestyle Medicine     Hybrid Journal   (Followers: 5)
American Journal of Managed Care     Full-text available via subscription   (Followers: 12)
American Journal of Medical Case Reports     Open Access   (Followers: 1)
American Journal of Medical Sciences and Medicine     Open Access   (Followers: 4)
American Journal of Medicine     Hybrid Journal   (Followers: 50)
American Journal of Medicine and Medical Sciences     Open Access   (Followers: 1)
American Journal of Medicine Studies     Open Access   (Followers: 2)
American Journal of Medicine Supplements     Full-text available via subscription   (Followers: 3)
American Journal of the Medical Sciences     Hybrid Journal   (Followers: 12)
American Journal on Addictions     Hybrid Journal   (Followers: 10)
American medical news     Free   (Followers: 3)
American Medical Writers Association Journal     Full-text available via subscription   (Followers: 5)
Amyloid: The Journal of Protein Folding Disorders     Hybrid Journal   (Followers: 5)
Anales de la Facultad de Medicina     Open Access  
Anales de la Facultad de Medicina, Universidad de la República, Uruguay     Open Access  
Anales del Sistema Sanitario de Navarra     Open Access   (Followers: 1)
Analgesia & Resuscitation : Current Research     Hybrid Journal   (Followers: 6)
Anatolian Clinic the Journal of Medical Sciences     Open Access  
Anatomica Medical Journal     Open Access  
Anatomical Science International     Hybrid Journal   (Followers: 3)
Anatomical Sciences Education     Hybrid Journal   (Followers: 1)
Anatomy     Open Access   (Followers: 2)
Anatomy Research International     Open Access   (Followers: 3)
Angewandte Schmerztherapie und Palliativmedizin     Hybrid Journal  
Angiogenesis     Hybrid Journal   (Followers: 3)
Ankara Medical Journal     Open Access   (Followers: 2)
Ankara Üniversitesi Tıp Fakültesi Mecmuası     Open Access  
Annales de Pathologie     Full-text available via subscription  
Annales des Sciences de la Santé     Open Access  
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale     Full-text available via subscription   (Followers: 3)
Annals of African Medicine     Open Access   (Followers: 2)
Annals of Anatomy - Anatomischer Anzeiger     Hybrid Journal   (Followers: 3)
Annals of Bioanthropology     Open Access   (Followers: 5)
Annals of Biomedical Engineering     Hybrid Journal   (Followers: 19)
Annals of Biomedical Sciences     Full-text available via subscription   (Followers: 4)
Annals of Clinical Hypertension     Open Access  
Annals of Clinical Microbiology and Antimicrobials     Open Access   (Followers: 14)
Annals of Family Medicine     Open Access   (Followers: 14)
Annals of Health Research     Open Access   (Followers: 1)
Annals of Ibadan Postgraduate Medicine     Open Access  
Annals of Medical and Health Sciences Research     Open Access   (Followers: 7)
Annals of Medicine     Hybrid Journal   (Followers: 12)
Annals of Medicine and Surgery     Open Access   (Followers: 7)
Annals of Microbiology     Hybrid Journal   (Followers: 13)
Annals of Nigerian Medicine     Open Access   (Followers: 1)
Annals of Rehabilitation Medicine     Open Access  
Annals of Saudi Medicine     Open Access  
Annals of the New York Academy of Sciences     Hybrid Journal   (Followers: 5)
Annals of The Royal College of Surgeons of England     Full-text available via subscription   (Followers: 3)
Annual Reports in Medicinal Chemistry     Full-text available via subscription   (Followers: 7)
Annual Reports on NMR Spectroscopy     Full-text available via subscription   (Followers: 5)
Annual Review of Medicine     Full-text available via subscription   (Followers: 17)
Anthropological Review     Open Access   (Followers: 24)
Anthropologie et santé     Open Access   (Followers: 5)
Antibiotics     Open Access   (Followers: 9)
Antibodies     Open Access   (Followers: 2)
Antibody Technology Journal     Open Access   (Followers: 1)
Antibody Therapeutics     Open Access  
Anuradhapura Medical Journal     Open Access  
Anwer Khan Modern Medical College Journal     Open Access   (Followers: 2)
Apmis     Hybrid Journal   (Followers: 1)
Apparence(s)     Open Access   (Followers: 1)
Applied Clinical Informatics     Hybrid Journal   (Followers: 4)
Applied Clinical Research, Clinical Trials and Regulatory Affairs     Hybrid Journal   (Followers: 2)
Applied Medical Informatics     Open Access   (Followers: 13)
Arab Journal of Nephrology and Transplantation     Open Access   (Followers: 1)
Archive of Clinical Medicine     Open Access   (Followers: 1)
Archive of Community Health     Open Access   (Followers: 1)
Archives Medical Review Journal / Arşiv Kaynak Tarama Dergisi     Open Access  
Archives of Asthma, Allergy and Immunology     Open Access  
Archives of Medical and Biomedical Research     Open Access   (Followers: 3)
Archives of Medical Laboratory Sciences     Open Access   (Followers: 1)
Archives of Medicine and Health Sciences     Open Access   (Followers: 4)
Archives of Medicine and Surgery     Open Access  
Archives of Trauma Research     Open Access   (Followers: 3)
Archivos de Medicina (Manizales)     Open Access  
ArgoSpine News & Journal     Hybrid Journal  
Arquivos Brasileiros de Oftalmologia     Open Access   (Followers: 1)
Arquivos de Ciências da Saúde     Open Access  
Arquivos de Medicina     Open Access  
Ars Medica : Revista de Ciencias Médicas     Open Access  
ARS Medica Tomitana     Open Access   (Followers: 1)
Art Therapy: Journal of the American Art Therapy Association     Hybrid Journal   (Followers: 17)
Arterial Hypertension     Open Access   (Followers: 1)
Artificial Intelligence in Medicine     Hybrid Journal   (Followers: 18)
Artificial Organs     Hybrid Journal   (Followers: 1)
ASHA Leader     Open Access  
Asia Pacific Family Medicine     Open Access   (Followers: 1)
Asia Pacific Journal of Clinical Nutrition     Full-text available via subscription   (Followers: 12)
Asia Pacific Journal of Clinical Trials : Nervous System Diseases     Open Access  
Asian Bioethics Review     Full-text available via subscription   (Followers: 3)
Asian Biomedicine     Open Access   (Followers: 2)
Asian Journal of Cell Biology     Open Access   (Followers: 5)
Asian Journal of Health     Open Access   (Followers: 3)
Asian Journal of Medical and Biological Research     Open Access   (Followers: 4)
Asian Journal of Medical and Pharmaceutical Researches     Open Access   (Followers: 2)
Asian Journal of Medical Sciences     Open Access   (Followers: 2)
Asian Journal of Scientific Research     Open Access   (Followers: 3)
Asian Journal of Transfusion Science     Open Access   (Followers: 1)
Asian Medicine     Hybrid Journal   (Followers: 5)
Asian Pacific Journal of Cancer Prevention     Open Access  
ASPIRATOR : Journal of Vector-borne Disease Studies     Open Access  
Astrocyte     Open Access  
Atención Familiar     Open Access  
Atención Primaria     Open Access   (Followers: 1)
Atti della Accademia Peloritana dei Pericolanti - Classe di Scienze Medico-Biologiche     Open Access  
Audiology - Communication Research     Open Access   (Followers: 10)
Auris Nasus Larynx     Full-text available via subscription  

        1 2 3 4 5 6 7 8 | Last

Similar Journals
Journal Cover
American Journal of Medicine
Number of Followers: 50  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0002-9343 - ISSN (Online) 1555-7162
Published by Elsevier Homepage  [3177 journals]
  • A common drug may help patients with debilitating migraine headaches
    • Abstract: Publication date: Available online 2 December 2019Source: The American Journal of MedicineAuthor(s): Joseph S. Alpert
       
  • THC Vaping-induced Acute Respiratory Distress Syndrome
    • Abstract: Publication date: Available online 30 November 2019Source: The American Journal of MedicineAuthor(s): Raed Qarajeh, Jacqueline Kitchen
       
  • Causes of Death in Patients with Acute and Chronic Myocardial Injury
    • Abstract: Publication date: Available online 30 November 2019Source: The American Journal of MedicineAuthor(s): Erik Kadesjö, Andreas Roos, Anwar J Siddiqui, Ulrik Sartipy, Martin J HolzmannAbstractBackgroundInformation about causes of death in patients with myocardial injury is limited. The purpose of this study was to explore causes of death in patients with myocardial injury.MethodsIn a cohort of 22,589 patients, 3,853 patients with myocardial injury were identified and categorized into: type 1 myocardial infarction, type 2 myocardial infarction, and non-ischemic acute and chronic myocardial injury. We included all 1,466/3,853 (38%) patients who died during follow-up (3.9 ± 2 years). We estimated rates and adjusted OR with 95% CI for causes of death in the four categories of myocardial injury using patients without myocardial injury 819/17,932 (4.6%) who died as reference.ResultsThe study cohort included 2,285 patients. The proportion of cardiovascular deaths was higher in patients with type 1 myocardial infarction (48%), acute (43%), and chronic (45%) myocardial injury and type 2 myocardial infarction (39%) compared with patients without myocardial injury (25%). Adjusted rates for cardiovascular death were similar in patients with myocardial injury. Type 1 myocardial infarction, acute, and chronic myocardial injury was associated with a 77% (OR: 1.77, 95% CI 1.29–2.41), 40% (OR: 1.40, 95% CI: 1.07-1.84), and 36% (OR: 1.36, 95% CI: 1.05-1.76) higher risk of cardiovascular death.ConclusionsPatients with type 1 myocardial infarction and acute or chronic myocardial injury have similar proportions and high risks for cardiovascular death. We believe that these findings stress the need for investigating patients without known heart diseases who present with non-ischemic myocardial injury, or type 2 myocardial infarction.
       
  • Pulmonary hypertension and pericardial effusions – to tap or not to
           tap
    • Abstract: Publication date: Available online 29 November 2019Source: The American Journal of MedicineAuthor(s): Ilya Y. Shadrin, Dame Idossa, Victoria Walston, John Lee, Meltiady Issa
       
  • Unusual case of dog-walker with Weil's disease
    • Abstract: Publication date: Available online 29 November 2019Source: The American Journal of MedicineAuthor(s): Joanna Lenik, Monil Majmundar, Gabriel Ibarra, Mohammad Saeed, Shobhana Chaudhari
       
  • A Meta-Analysis of Aspirin for the Primary Prevention of Cardiovascular
           Diseases in the Context of Contemporary Preventive Strategies
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): Rahman Shah, Babar Khan, Samuel B. Latham, Sajjad A. Khan, Sunil V. RaoAbstractBackgroundThe role of aspirin for primary prevention of cardiovascular diseases remains controversial, particularly in the context of contemporary aggressive preventive strategies.MethodsRelevant randomized clinical trials were included, and risk ratios (RRs) were calculated using random-effects models. Additional moderator analyses were performed to compare the pooled treatment effects from recent trials (those reported after the guidelines of the National Cholesterol Education Program Third Adult Treatment Panel were published in 2001; thus, conducted on the background of contemporary preventive strategies) to the results of older trials.ResultsData from 14 randomized controlled trials involving 164,751 patients were included. Aspirin use decreased myocardial infarction risk by 16% compared with placebo (RR 0.84; 95% confidence interval [CI], 0.75-0.94); however, in the moderator analyses, aspirin was not associated with a decreased risk of myocardial infarction in recent trials, but was in older trials (P-interaction = .02). Overall, aspirin use significantly increased the occurrence of major bleeding (RR 1.49; 95% CI, 1.32-1.69) and hemorrhagic stroke (RR 1.25; 95% CI, 1.01-1.54). In moderator analyses, the risk of major bleeding (P-interaction = .12) or hemorrhagic stroke (P-interaction = .44) with aspirin was not significantly different between the older and new trials. Differences between aspirin and placebo in the risks for all-cause stroke, cardiac death, and all-cause mortality were not found.ConclusionsIn the context of contemporary primary prevention guidelines, the effect of aspirin on myocardial infarction risk was significantly attenuated, whereas its major bleeding and hemorrhagic stroke complications were retained. Therefore, in contemporary practice, routine use of aspirin for the primary prevention of cardiovascular events may have a net harmful effect.
       
  • Pay Air-Tension: Anorexia and Tension Pneumomediastinum
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): Louisa Cheong, Esabella Sheng-Ting Koh, Desmond Boon-Seng Teo
       
  • A Paralyzing Vacation: Surfer’s Myelopathy
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): Michael X. Yang, Mark J. Ault
       
  • A Pregnant Woman with Anterior Chest Mass and Respiratory Failure:
           Blastomycosis in a Historically Nonendemic Area
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): Adam Austin, David M. Jones, Amit Chopra
       
  • COPD: To Be or Not to Be, That is the Question
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): Francesca Polverino, Afshin Sam, Stefano GuerraAbstractAs our knowledge on the natural history of chronic obstructive pulmonary disease (COPD) progresses, a conceptual model simply based on an accelerated decline of lung function in adult life in response to smoking has become inadequate to capture the complexity of this disease, and increasing attention is being given to possible contributions from events or alterations of developmental processes that take place earlier in life. In addition, a remarkable heterogeneity has emerged among the pathobiological mechanisms that are involved in different phenotypes of COPD, suggesting that an effective disease management will require individualized treatment approaches largely based on the underlying biological mechanisms (endotypes). In this review, we will discuss the many faces of COPD from an epidemiological, pathobiological, and clinical standpoint and argue that airflow limitation encompasses a number of manifestations that are too diverse to be still clustered under the same diagnostic label.
       
  • Cannabis and Cannabinoids: Kinetics and Interactions
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): Brian C. Foster, Hanan Abramovici, Cory S. HarrisAbstractCannabis sativa and related products are widely used, but their potential to cause significant clinical interactions remains unclear, particularly for cannabinoid-enriched or otherwise concentrated products. The pharmacokinetics of most cannabis products is not known. Where information is known, there is wide variation. Extrapolation of limited clinical data is complicated by the complexity and variability of cannabis products as well as their delivery through various routes of administration. In vitro evidence shows that the major cannabinoids are substrates for numerous metabolic enzymes, including the cytochrome P450 metabolizing enzymes. Whereas many consumers consider cannabis products to be safe relative to alternative prescription or narcotic drugs, clinical reports of cannabis-related drug interactions and adverse events are increasing in frequency. Patients using these products, whether for medical or nonmedical purposes, together with conventional therapeutic agents may be at increased risk of adverse events, including therapeutic failure, and require enhanced monitoring.
       
  • America’s Health Care System Is Broken: What Went Wrong and How We Can
           Fix It. Part 6: Social Factors
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): Edward P HofferAbstractAlthough previous articles in the series have focused on the key players in our health care system, even larger factors that impact the cost and outcome of the nation’s health lie in areas that are not traditionally thought of as “health care.” Diet and exercise play a huge role in longevity and well-being. The best health care systems are unable to do much to lower deaths from firearms and motor vehicle crashes. Changing our focus from health care institutions to how to better support patients in the community will both lower cost and improve satisfaction. We need to learn how to better integrate patients’ wishes into end-of-life care to provide more humanistic as well as less expensive care.
       
  • Testing Healthcare Workers for Latent Tuberculosis: Is It Evidence Based,
           Bio-Plausible, Both, Or Neither'
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): Jennifer Gill, Vinay Prasad
       
  • Challenging Anticoagulation in Advanced Renal Failure
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): Hanz-Peter Marti, Victor Serebruany, Dan Atar
       
  • The Purpose of the Medical Record: Why Lawrence Weed Still Matters
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): Mark D. Aronson
       
  • Laying Hands on the Patient Who Is Unstable: Bedside Diagnosis in Medical
           Emergencies
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): Michael Y. Lin, Mukund Ramkumar, John F. Kugler
       
  • Discriminatory and Sexually Inappropriate Remarks from Patients and Their
           Challenge to Professionalism
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): David Alfandre, Cynthia Geppert
       
  • Common Sense and Medical Practice
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): Joseph S. Alpert
       
  • On Becoming a Doctor
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): Arthur L. Frank
       
  • Latent Tuberculosis Infection: Treatment Initiation and Completion Rates
           in Persons Seeking Immigration and Health Care Workers
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): Amos Lal, Ahmed Al Hammadi, Alwyn RaposeAbstractBackgroundWe assessed the factors associated with initiation and completion rates of latent tuberculosis (TB) infection treatment in persons evaluated at an infectious diseases outpatient clinic in central Massachusetts. The Centers for Disease Control and Prevention (CDC) estimates that there may be up to 14 million persons in the United States with a latent TB infection. The risk of developing active TB in these persons can range from 5% to 15%. Hence, treatment of latent TB infection is an important aspect of any plan attempting to eradicate TB from the United States.MethodsWe performed a retrospective chart review of patients referred to our outpatient infectious diseases clinic from December 2006 to October 2010.ResultsOverall treatment initiation and completion rates were 76% and 68%, respectively, in our cohort. Two factors that were statistically significant for higher rates of treatment completion were 4 or more follow-up visits during the course of treatment (P < 0.001) and persons seeking immigration (PSI) to the United States (P < 0.02). Rate of treatment refusal was higher in health care workers as compared to workers not in health care (35% vs 13%, P = 0.004, 95% confidence interval [CI]: 1.38-4.91).ConclusionOur study reveals findings not previously reported in the US literature. We noted a high rate of treatment completion in persons seeking immigration to the United States. The second unique observation is the higher treatment completion rates in persons with 4 or more follow-up visits. We suggest that an emphasis on at least 4 follow-up visits can be an intervention that could improve the overall rates of treatment completion.
       
  • The Reply
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): Anusha M. Kumar, Gordon H. Bae, Justin Besen, Bernice Y. Kwong, Kerri E. Rieger
       
  • Occam’s Razor and Its Ethical Implications in Eosinophilic
           Granulomatosis With Polyangiitis
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): Oscar M.P. Jolobe
       
  • The Reply
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): John A. Dodson, Alexandra Hajduk, Sarwat I. Chaudry
       
  • Geriatric Conditions and Acute Kidney Injury: A Lack of Association or
           Over-Adjustment'
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): Letian Yang, Yuliang Zhao, Ping Fu
       
  • The Reply
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): Aaron R. Folsom, Saonli Basu, Ching-Ping Hong, Susan R. Heckbert, Pamela L. Lutsey, Wayne D. Rosamond, Mary Cushman, for the Atherosclerosis Risk in Communities (ARIC) Study
       
  • Risk Factors for Venous Thromboembolism
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): GuanYang Kang, HuiQing Zhang
       
  • The Consequences of Untreated Gout: Is this a Tophus'
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): Jaren R. Trost, Konstantin N. Konstantinov
       
  • Meigs’ Syndrome: A Sheep in Wolf's Clothing
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): Jenny A. Shih, Leslie A. Garrett, Alexander R. Carbo
       
  • Paraneoplastic Migratory Oligoarthritis in a Patient With Malignant
           Mesothelioma
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): Matthew Eidenschink, Albertine Beard, David Ewart
       
  • Carbonic Anhydrase Inhibitors for the Treatment of High-Altitude Hypoxemia
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): Philip L. Hooper, Erik R. Swenson, Richard J. Johnson
       
  • Allergic Bronchopulmonary Candidiasis Mimicking COPD
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): Denis Caillaud, Frederic Costes, Philippe Chalmet, Florent Payen
       
  • Retrieved Arterial Clot Helps Guide Antibiotic Therapy in Infective
           Endocarditis
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): Lama Abdel-Wahed, Amir Shaban, Minako Hayakawa, Kaustubh Limaye
       
  • A Case of ‘Pernicious Angina’
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): Michelle D. Lundholm, Laurent Loganathan, Amit Dayal, Brian Schmitt
       
  • Erratum to ‘Don't Move a Muscle: A Case of Diabetic
           Myonecrosis’
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): Margaret Ivanov, Bilal Asif, Rebecca Jaffe
       
  • Point-of-Care Ultrasound for Internal Medicine Residency Training: A
           Position Statement from the Alliance of Academic Internal Medicine
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): Charles M. LoPresti, Trevor P. Jensen, Renee K. Dversdal, Donna J. Astiz
       
  • Prostate Artery Embolization in Patients With Acute Urinary Retention
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): Alberto G. Kenny, Olivier Pellerin, Gregory Amouyal, François Desgranchamps, Paul Méria, Amaury De Gouvello, Charles Dariane, Carole Déan, Helena Pereira, Nicolas Thiounn, Marc SapovalAbstractBackgroundThis prospective study assessed the efficacy of prostate artery embolization after failure of a trial without catheter in patients suffering a first episode of acute urinary retention as a result of benign prostatic hyperplasia (BPH).MethodsPatients with failure of a trial without catheter despite alpha-blocker therapy were invited to participate in this protocol. Twenty patients were included in the study, and all underwent prostate artery embolization with calibrated polyvinyl alcohol (PVA) microspheres (Bead Block, BTG Ltd., Farnham, UK).ResultsSuccessful removal of the indwelling bladder catheter and spontaneous voiding was achieved in 15 of 20 (75%) patients, and the overall clinical success at 6 months after prostate embolization was 14 of 20 (70%). No patient experienced severe adverse events.ConclusionsProstate artery embolization might be a valuable treatment after a failure of a trial without catheter. Further studies are needed to better define its place in this setting.
       
  • Western Osteoporosis Alliance Clinical Practice Series: Treat-to-Target
           for Osteoporosis
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): E. Michael Lewiecki, David L. Kendler, K. Shawn Davison, David A. Hanley, Steven T. Harris, Michael R. McClung, Paul D. MillerAbstractPatients often start treatment to reduce fracture risk because of a bone mineral density T-score consistent with osteoporosis (≤ −2.5). Others with a T-score above −2.5 may be treated when there is a history of fragility fracture or when a fracture risk algorithm categorizes them as having a high risk for fracture. It is common to initiate therapy with a generic oral bisphosphonate, unless contraindicated, and continue therapy if the patient is responding as assessed by stability or an increase in bone mineral density. However, some patients may respond well to an oral bisphosphonate, yet remain with an unacceptably high risk for fracture. Recognition of this occurrence has led to the development of an alternative strategy: treat-to-target. This involves identifying a biological marker (treatment target) that represents an acceptable fracture risk and then initiating treatment with an agent likely to reach this target. If the patient is on a path to reaching the target with initial therapy, treatment is continued. If it appears the target will not be reached with initial therapy, treatment is changed to an agent more likely to achieve the goal.
       
  • The Great Masquerador: A Young Female with Multiple Endocrine Neoplasia
           Type 2A and Bilateral Pheochromocytomas
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): Marvin Wei Jie Chua, Kathleen Su-Yen Sek, E. Shyong Tai
       
  • Universal Multigene Panel Testing in all Breast Cancer Patients
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): Steven Sorscher
       
  • When It Works
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): Jack Ende
       
  • Is Any Patient with Chronic Heart Failure Receiving the Right Dose of the
           Right Beta-Blocker in Primary Care'
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): Milton Packer
       
  • Cannabis Use and Markers of Systemic Inflammation: The Coronary Artery
           Risk Development in Young Adults Study
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): Omayma Alshaarawy, Stephen Sidney, Reto Auer, David Green, Elsayed Z. Soliman, David C. Goff, James C. AnthonyAbstractBackgroundIt is unclear whether cannabis use in humans plays a role in the regulation of inflammatory responses. This study aimed to examine cannabis-attributable immunomodulation as manifested in levels of fibrinogen, C-reactive protein (CRP), and interleukin-6 (IL-6).MethodsThe Coronary Artery Risk Development in Young Adults (CARDIA) study is a cohort of 5115 African-American and Caucasian males and females enrolled in 1985-1986, and followed up for over 25 years, with repeated measures of cannabis use. Fibrinogen levels were measured at year 5, year 7, and year 20, CRP levels were measured at year 7, year 15, year 20, and year 25, and IL-6 levels were measured at year 20. We estimated the association of cannabis use and each biomarker using generalized estimating equations adjusting for demographic factors, tobacco cigarette smoking, alcohol drinking, and body mass index.ResultsCompared with never use (reference), recent cannabis use was not associated with any of the biomarkers studied here after adjusting for potential confounding variables. Former cannabis use was inversely associated with fibrinogen levels (β = −5.4; 95% confidence interval [CI], −9.9, −0.9), whereas the associations were weaker for serum CRP (β = −0.02; 95% CI, −0.10, 0.06) and IL-6 (β = −0.06; 95% CI, −0.13, 0.02).ConclusionsA modest inverse association between former cannabis use and fibrinogen was observed. Additional studies are needed to investigate the immunomodulatory effects of cannabis while considering different cannabis preparation and mode of use.
       
  • Digoxin Use and Outcomes in Patients With Heart Failure With Reduced
           Ejection Fraction
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): Syed Z. Qamer, Awais Malik, Essraa Bayoumi, Phillip H. Lam, Steven Singh, Milton Packer, Ioannis E. Kanonidis, Charity J. Morgan, Ahmed Abdelmawgoud, Richard M. Allman, Gregg C. Fonarow, Ali AhmedAbstractBackgroundHeart failure is a leading cause for hospital readmission. Digoxin use may lower this risk in patients with heart failure with reduced ejection fraction (HFrEF), but data on contemporary patients receiving other evidence-based therapies are lacking.MethodsOf the 11,900 patients with HFrEF (ejection fraction ≤ 45%) in Medicare-linked OPTIMIZE-HF, 8401 were not on digoxin, of whom 1571 received discharge prescriptions for digoxin. We matched 1531 of these patients with 1531 not receiving digoxin by propensity scores for digoxin use. The matched cohort (n = 3062; mean age, 76 years; 44% women; 14% African American) was balanced on 52 baseline characteristics. We assembled a second matched cohort of 2850 patients after excluding those with estimated glomerular filtration rate
       
  • High-Intensity Statins Are Associated With Increased Incidence of
           Hypoglycemia During Hospitalization of Individuals Not Critically Ill
    • Abstract: Publication date: November 2019Source: The American Journal of Medicine, Volume 132, Issue 11Author(s): Israel Khanimov, Gadi Segal, Julio Wainstein, Mona Boaz, Mordechai Shimonov, Eyal LeibovitzAbstractBackgroundSerum cholesterol is inversely associated with incident hypoglycemia among patients admitted to internal medicine wards. We examined the association between statin use and incidence of hypoglycemia among patients who were not critically ill.MethodsIn this retrospective study, we included all patients discharged between January 1, 2010, to December 31, 2013 from internal medicine units at the Wolfson Medical Center. Excluded were patients with hepatocellular or cholestatic liver disease upon admission. Patients were allocated to 4 groups, according to diabetes mellitus status (yes or no) and serum albumin
       
  • The Anti-Platelet Anomaly: Aspirin/Dipyridamole-Induced Acute Pancreatitis
    • Abstract: Publication date: Available online 18 November 2019Source: The American Journal of MedicineAuthor(s): Daniel J. DeSantis, Punam B. Patel, Ludmila Gerova, Derek W. Grady
       
  • Bleeding risk in elderly patients receiving anticoagulant therapy: Should
           dosage be reduced'
    • Abstract: Publication date: Available online 18 November 2019Source: The American Journal of MedicineAuthor(s): Joseph S. Alpert
       
  • Cannabinoid oil vaping associated lung injury and its radiographic
           appearance
    • Abstract: Publication date: Available online 18 November 2019Source: The American Journal of MedicineAuthor(s): Edward J Conuel, Hau C Chieng, John Fantauzzi, Kiran Pokhrel, Chananya Goldman, Thomas C Smith, Anupama Tiwari, Amit Chopra, Marc A. JudsonAbstractBackgroundLung injury associated with cannabinoid oil vaping is rapidly becoming a serious public health concern. We describe the clinical and radiographic presentations of five patients with lung injury associated with vaping cannabinoid oils seen at a single institution.ResultsOf the five patients with suspected vaping associated lung injury seen at our institution, four required supplemental oxygen, and all these four were admitted to the hospital. Three patients required admission to the Intensive Care Unit. None of the patients required mechanical ventilation. All patients demonstrated a consistent radiologic appearance of diffuse bilateral ground-glass lung opacities that spared the extreme periphery. Three patients underwent bronchoalveolar lavage (BAL), which revealed lipid-laden macrophages in two of them. All patients were successfully discharged from the hospital. Four received only supportive care, while the fifth required intravenous followed by oral corticosteroids.ConclusionsWe report the clinical and radiographic presentation of five patients at our institution with cannabinoid oil vaping associated lung injury. All patients displayed a consistent chest radiographic pattern of injury. Most responded to supportive care, although one required the addition of corticosteroids. BAL results suggest that this injury may related to a toxic form of lipoid pneumonia.
       
  • Severe atypical pneumonia causing acute respiratory failure
    • Abstract: Publication date: Available online 18 November 2019Source: The American Journal of MedicineAuthor(s): Eva Luderowski, Che Matthew Harris, Waseem Khaliq, Susrutha Kotwal
       
  • Kaposi's sarcoma occurring in HIV infection controlled on HAART
    • Abstract: Publication date: Available online 18 November 2019Source: The American Journal of MedicineAuthor(s): Karolina Louisa Suzanna Kerkemeyer, Adrian Mar, Francis Yi Xing Lai
       
  • Relationship of nutritional status, inflammation, and serum albumin levels
           during acute illness: A prospective study
    • Abstract: Publication date: Available online 18 November 2019Source: The American Journal of MedicineAuthor(s): Andreas Eckart, Tristan Struja, Alexander Kutz, Annic Baumgartner, Thomas Baumgartner, Seline Zurfluh, Olivia Neeser, Andreas Huber, Zeno Stanga, Beat Mueller, Philipp SchuetzAbstractBackgroundLow serum albumin levels resulting from inflammation-induced capillary leakage or disease-related anorexia during acute illness are associated with poor outcomes. We investigated the relationship of nutritional status and inflammation with low serum albumin levels and 30-day mortality in a large cohort.MethodsWe prospectively enrolled adult patients in the medical emergency department of a Swiss tertiary care center and investigated associations of C-reactive protein (CRP) and Nutritional Risk Screening (NRS 2002) as markers of inflammation and poor nutritional status, respectively, with low serum albumin levels and mortality using multivariate regression analyses.ResultsOf 2,465 patients, 1,019 (41%) had low serum albumin levels (20mg/L. Multivariate analyses adjusted for age, gender, diagnosis, and comorbidities revealed elevated CRP values (adjusted odds ratio [OR] 10.51, 95% confidence intervals [CI] 7.51 to 14.72, P
       
  • Diffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia – An
           Asthma Mimicker
    • Abstract: Publication date: Available online 17 November 2019Source: The American Journal of MedicineAuthor(s): Leonard Riley, Selina Sutchu, Li Lu, Daniel Urbine
       
  • Risk factors for heart failure in the community: differences by age and
           ejection fraction
    • Abstract: Publication date: Available online 17 November 2019Source: The American Journal of MedicineAuthor(s): Alanna M. Chamberlain, Cynthia M. Boyd, Sheila M. Manemann, Shannon M. Dunlay, Yariv Gerber, Jill M. Killian, Susan A. Weston, Véronique L. RogerABSTRACTBackgroundDifferences in comorbid conditions in heart failure patients compared to population controls, and whether differences exist by type of heart failure or age, has not been well documented.MethodsThe prevalence of 17 chronic conditions were obtained in 2643 incident heart failure patients from 2000-2013 and controls matched 1:1 on sex and age from Olmsted County, MN. Logistic regression determined associations of each condition with heart failure.ResultsAmong 2643 matched pairs (mean age 76.2 years, 45.6% men), the comorbidities with the largest attributable risk of heart failure were arrhythmia (48.7%), hypertension (28.4%), and coronary artery disease (33.9%); together these explained 73.0% of heart failure. Similar associations were observed for patients with reduced and preserved ejection fraction, with the exception of hypertension. The risk of heart failure attributable to hypertension was two-fold higher in heart failure with preserved ejection fraction (38.7%) than heart failure with reduced ejection fraction (17.8%). Hypertension, coronary artery disease, arrhythmia, and diabetes were more strongly associated with heart failure in younger (≤75 years) compared to older (>75 years) persons.ConclusionsHeart failure patients have a higher prevalence of many chronic conditions than controls. Similar associations were observed in patients with reduced and preserved ejection fraction, with the exception of hypertension which was more strongly associated with heart failure with preserved ejection fraction. Finally, some cardiometabolic risk factors were more strongly associated with heart failure in younger persons, highlighting the importance of optimizing prevention and treatment of risk factors, and in particular cardiometabolic risk factors.
       
  • Acute Encephalopathy Leading to a New Diagnosis of Hereditary Hemorrhagic
           Telangiectasia in a Young Male
    • Abstract: Publication date: Available online 17 November 2019Source: The American Journal of MedicineAuthor(s): Joana Diaz, Ashley M. Rose, Sean Meader
       
  • Association of erectile dysfunction with incident atrial fibrillation: the
           Multi-Ethnic Study of Atherosclerosis (MESA)
    • Abstract: Publication date: Available online 16 November 2019Source: The American Journal of MedicineAuthor(s): Yoshihiro Tanaka, Joshua D. Bundy, Norrina B. Allen, S.M. Iftekhar Uddin, David I. Feldman, Erin D. Michos, Susan R. Heckbert, Philip GreenlandAbstractBackgroundErectile dysfunction has been associated with atrial fibrillation in cross-sectional studies, but the association of erectile dysfunction with incident atrial fibrillation is less well established.PurposeTo determine whether erectile dysfunction is independently associated with incident atrial fibrillation after adjusting for conventional risk factors.MethodsWe studied 1760 male participants (mean age 68 ± 9 years) from the Multi-Ethnic Study of Atherosclerosis (MESA), who completed self-reported erectile dysfunction assessment at MESA Exam 5 (2010-2012). Cumulative incidence of atrial fibrillation was estimated by Kaplan-Meier analysis. Cox proportional hazards regression was used to calculate the unadjusted and adjusted hazard ratios (HR) using three models in which variables were added in a stepwise manner. In Model 3, HR was adjusted for age, race/ethnicity, education, smoking status, alcohol use, systolic blood pressure, body mass index, diabetes, anti-hypertensive medication use, lipid-lowering medication use, total cholesterol, and estimated glomerular filtration rate.ResultsDuring the median follow-up of 3.8 (interquartile range, 3.5 – 4.2) years, 94 cases of incident atrial fibrillation were observed. There was a significant difference between men with and without erectile dysfunction for cumulative incident atrial fibrillation rates at 4 years (9.6 vs 2.9%, respectively, p < 0.01). In the fully adjusted model, erectile dysfunction remained associated with incident atrial fibrillation (Model 3; HR, 1.66; 95% Confidence Interval 1.01 – 2.72, p = 0.044).ConclusionsAmong older male participants in this prospective study, we found that self-reported erectile dysfunction was associated with incident atrial fibrillation.
       
  • “Rethinking Medical Journal Club”
    • Abstract: Publication date: Available online 16 November 2019Source: The American Journal of MedicineAuthor(s): Alec L. Meleger, John Patrick T. Co, Ross D. Zafonte
       
  • Limitations of Electrocardiography for Detecting Left Ventricular
           Hypertrophy or Concentric Remodeling in Athletes
    • Abstract: Publication date: Available online 15 November 2019Source: The American Journal of MedicineAuthor(s): Kristofer Hedman, Kegan J Moneghetti, David Hsu, Jeffrey W Christle, Alessandro Patti, Euan Ashley, David Hadley, Francois Haddad, Victor FroelicherAbstractBackgroundElectrocardiography (ECG) is used to screen for left ventricular hypertrophy (LVH), but common ECG-LVH criteria have been found less effective in athletes. The purpose of this study was to comprehensively evaluate the value of ECG for identifying athletes with LVH or a concentric cardiac phenotype.MethodsA retrospective analysis of 196 male Division I college athletes routinely screened with ECG and echocardiography within the Stanford Athletic Cardiovascular Screening Program was performed. Left-ventricular mass and volume were determined using echocardiography. LVH was defined as left ventricular mass (LVM)> 102 g/m²; a concentric cardiac phenotype as LVM-to-volume (M/V) ≥ 1.05 g/mL. Twelve-lead electrocardiograms including high-resolution time intervals and QRS voltages were obtained. Thirty-seven previously published ECG-LVH criteria were applied, of which the majority have never been evaluated in athletes. C-statistics, including area under the receiver operating curve (AUC) and likelihood ratios were calculated.ResultsECG lead voltages were poorly associated with LVM (r = 0.18-0.30) and M/V (r = 0.15-0.25). The proportion of athletes with ECG-LVH was 0%-74% across criteria, with sensitivity and specificity ranging between 0% and 91% and 27% and 99.5%, respectively. The average AUC of the criteria in identifying the 11 athletes with LVH was 0.57 (95% confidence interval [CI] 0.56-0.59), and the average AUC for identifying the 8 athletes with a concentric phenotype was 0.59 (95% CI 0.56-0.62).ConclusionThe diagnostic capacity of all ECG-LVH criteria were inadequate and, therefore, not clinically useful in screening for LVH or a concentric phenotype in athletes. This is probably due to the weak association between LVM and ECG voltage.
       
  • The Quiet Hum: Pulmonary Arteriovenous Malformations and Hereditary
           Hemorrhagic Telangiectasia
    • Abstract: Publication date: Available online 9 November 2019Source: The American Journal of MedicineAuthor(s): Benjamin D. Fiore, Matthew C. Russell, Michael F. Powers, Janet N. Myers
       
  • Reversible cause of Neuropathy and Monoclonal Gammopathy Of Renal
           Significance
    • Abstract: Publication date: Available online 9 November 2019Source: The American Journal of MedicineAuthor(s): Garima Dabas, Tarun Narang, Rajesh Kumar, Ritambhra Nada, Sunil Dogra, Krishan Lal Gupta, Raja Ramachandran
       
  • Identifying Solutions to Ambulatory Faculty Recruitment, Retention, and
           Remuneration in Graduate Medical Education: an AAIM Position Paper
    • Abstract: Publication date: Available online 9 November 2019Source: The American Journal of MedicineAuthor(s): Margaret C. Lo, Jonathan Tolentino, Sara B. Fazio, Steve Vinciguerra, Alpesh N. Amin, Andrew Dentino, Susan T. Hingle, Kerri Palamara, Isitri Modak, Michael Kisielewski, John P. Moriarty
       
  • Parvovirus B19 Infection with Positive Rumpel-Leede Sign
    • Abstract: Publication date: Available online 9 November 2019Source: The American Journal of MedicineAuthor(s): Junki Mizumoto
       
  • Hyperphosphatemia and multiple myeloma: keep calm and control first
    • Abstract: Publication date: Available online 9 November 2019Source: The American Journal of MedicineAuthor(s): Charlotte Boud'hors, Morgane Le Gallo, Corentin Orvain, Françoise Larcher, Martine Gardembas, Jean-François Augusto, Julien Demiselle
       
  • A Fuzzy Cause of Hip Pain
    • Abstract: Publication date: Available online 9 November 2019Source: The American Journal of MedicineAuthor(s): David L. Leverenz, Lisa G. Criscione-Schreiber
       
  • Rigid ears and hyperpigmentation in Addison's disease
    • Abstract: Publication date: Available online 9 November 2019Source: The American Journal of MedicineAuthor(s): Ko Harada, Fumio Otsuka
       
  • A Latin American patient with a left ventricular pseudoaneurysm presenting
           with progressive dyspnea and palpitations
    • Abstract: Publication date: Available online 9 November 2019Source: The American Journal of MedicineAuthor(s): Andrés F. Henao-Martínez, Solana Archuleta, Daniel Vargas, Carlos Franco-Paredes
       
  • Outcomes of Acute Myocardial Infarction in Patients with Influenza and
           Other Viral Respiratory Infections
    • Abstract: Publication date: October 2019Source: The American Journal of Medicine, Volume 132, Issue 10Author(s): Pimprapa Vejpongsa, Danai Kitkungvan, Mohammad Madjid, Konstantinos Charitakis, H. Vernon Anderson, Salman Arain, Prakash Balan, Richard W. Smalling, Abhijeet DhobleAbstractBackgroundAcute influenza infection can trigger acute myocardial infarction, however, outcome of patients with acute myocardial infarction during influenza infection is largely unknown.MethodsPatients ≥ 18 years old with ST-elevation and non-ST-elevation myocardial infarction during January 2013-December 2014 were identified using the National Inpatient Sample. The clinical outcomes were compared among patients who had no respiratory infection to the ones with influenza and other viral respiratory infections using propensity score-matched analysis.ResultsOf 1,884,985 admissions for acute myocardial infarction, acute influenza and other viral infections were diagnosed in 9,885 and 11,485 patients, respectively, accounting for 1.1% of patients. Acute myocardial infarction patients with concomitant influenza infection had a worse outcome than those with acute myocardial infarction alone, in terms of in-hospital case fatality rate, development of shock, acute respiratory failure, acute kidney injury, and higher rate of blood transfusion after propensity scores. The length of stay is also significantly longer in influenza patients with acute myocardial infarction, compared with patients with acute myocardial infarction alone. However, patients who developed acute myocardial infarction during other viral respiratory infection have a higher rate of acute respiratory failure but overall lower mortality rate, and are less likely to develop shock or require blood transfusion after propensity match. Despite presenting with acute myocardial infarction, less than one-fourth of patients with concomitant influenza infection underwent coronary angiography, but more than half (51.4%) required revascularization.ConclusionInfluenza infection is associated with worse outcomes in acute myocardial infarction patients, and patients were less likely to receive further evaluation with invasive coronary angiography.
       
  • Otogenic Pneumocephalus Presenting as Pneumatocele of the Scalp
    • Abstract: Publication date: October 2019Source: The American Journal of Medicine, Volume 132, Issue 10Author(s): Mercy George, Vincent Dunet, Stephen Alzuphar, Francois Borsotti, Roy Thomas Daniel, Christian Simon
       
  • Don’t Trip Over the Trop: An Unusual Presentation of Thyrotoxic
           Periodic Paralysis
    • Abstract: Publication date: October 2019Source: The American Journal of Medicine, Volume 132, Issue 10Author(s): Norildin Al-Refaie, Shweta Appiah, Amit K.J. Mandal, Constantinos G. Missouris
       
  • Abnormal Chest Radiograph in Rapidly Progressive Glomerulonephritis—Not
           the Usual Pulmonary-Renal Syndrome
    • Abstract: Publication date: October 2019Source: The American Journal of Medicine, Volume 132, Issue 10Author(s): Jamie X.L. Kee, Jason C.J. Choo, Angela M. Takano, Syed S. Ahmed, Irene Y.J. Mok, Cynthia C. Lim
       
  • Keeping a Low Profile: Insulinoma
    • Abstract: Publication date: October 2019Source: The American Journal of Medicine, Volume 132, Issue 10Author(s): Ramzi Dudum, Vivek K. Murthy
       
  • Fish Oil and Cardiometabolic Diseases: Recent Updates and Controversies
    • Abstract: Publication date: October 2019Source: The American Journal of Medicine, Volume 132, Issue 10Author(s): Ramyashree Tummala, Raktim Kumar Ghosh, Vardhmaan Jain, Arvind Reddy Devanabanda, Dhrubajyoti Bandyopadhyay, Prakash Deedwania, Wilbert S. AronowAbstractFatty acids derived from fish oil are long-chain omega-3 (n-3) polyunsaturated fatty acids. The important polyunsaturated fatty acids of fish oil are eicosapentaenoic acid, and docosahexaenoic acid. For decades, there has been a debate about the use of omega-3 fatty acids and their benefits on cardiovascular health. The more recent trials including the JELIS, VITAL, STRENGTH, and ASCEND trials, addressed the paucity of data of omega-3 fatty acids on primary and secondary prevention of cardiovascular events and the risk-benefit balance of these supplements. Prior to these studies, many large randomized controlled trials have shown conflicting results on the effect of polyunsaturated fatty acids in patients with prior coronary artery disease, stroke, or major vascular events. These inconsistent results warrant a better understanding of the effects of omega-3 fatty acids on the subtypes of cardiovascular diseases, and their use in primary and secondary prevention. More recently, icosapent ethyl showed a significant reduction in cardiovascular mortality and ischemic events in patients with elevated triglyceride (TG) and established cardiovascular disease or diabetes. The REDUCE-IT trial paved the way to further reduce cardiovascular risk in patients with high TG despite being on a maximally tolerated statin. The aim of this review is to discuss these recent updates on the use of various forms of fish oil, including prescription form and supplement in cardiometabolic diseases, and their surrounding controversies.
       
  • Is It Possible to Make a Correct Diagnosis of Lyme Disease on Symptoms
           Alone' Review of Key Issues and Public Health Implications
    • Abstract: Publication date: October 2019Source: The American Journal of Medicine, Volume 132, Issue 10Author(s): Phillip J. BakerAbstractThere is much confusion and misinformation about the diagnosis of Lyme disease, as well as its treatment. This review explains why one cannot make a correct diagnosis of Lyme disease based on symptoms alone. It also provides evidence to support the validity of two-tier testing for the laboratory diagnosis of Lyme disease. The public health consequences of failing to consider these issues are discussed.
       
  • A Clinical Approach to Diagnosing Encephalopathy
    • Abstract: Publication date: October 2019Source: The American Journal of Medicine, Volume 132, Issue 10Author(s): Michael G. Erkkinen, Aaron L. BerkowitzAbstractEncephalopathy refers to dysfunction of the level or contents of consciousness due to brain dysfunction and can result from global brain insults or focal lesions. The underlying causes of encephalopathy include both primary neurologic and systemic conditions. This article discusses the differential diagnosis of encephalopathy, with a focus on primary neurologic causes. A practical schema for organizing the differential diagnosis is to group etiologies by their pace of onset and evolution (eg, sudden, acute, subacute, chronic).
       
  • Peripheral Artery Disease: Past, Present, and Future
    • Abstract: Publication date: October 2019Source: The American Journal of Medicine, Volume 132, Issue 10Author(s): Umberto Campia, Marie Gerhard-Herman, Gregory Piazza, Samuel Z. GoldhaberAbstractPeripheral artery disease is a prevalent but underdiagnosed manifestation of atherosclerosis. There is insufficient awareness of its clinical manifestations, including intermittent claudication and critical limb ischemia and of its risk of adverse cardiovascular and limb outcomes. In addition, our inadequate knowledge of its pathophysiology has also limited the development of effective treatments, particularly in the presence of critical limb ischemia. This review aims to highlight essential elements of the epidemiology and pathophysiology of peripheral artery disease, bring attention to the often-atypical manifestations of occlusive arterial disease of the lower extremity, increase awareness of critical limb ischemia, briefly describe the diagnostic role of the ankle brachial index, and go over the contemporary management of peripheral artery disease. An emphasis is placed on evidence-based medical treatments to improve symptoms and quality of life and to reduce the risk of cardiovascular and limb events in these patients, including supervised exercise training, smoking cessation, antagonism of the renin-angiotensin system, lipid-lowering, antiplatelet, and antithrombotic therapies.
       
  • America’s Health Care System Is Broken: What Went Wrong and How We Can
           Fix It. Part 5: Malpractice, Fraud, Waste, and the EMR
    • Abstract: Publication date: October 2019Source: The American Journal of Medicine, Volume 132, Issue 10Author(s): Edward P. HofferAbstractAlthough the exact sums can only be estimated, large amounts of money are wasted by the US health care system through fraud and by spending on tests, procedures, and treatments that are of no proven benefit. The adversarial fault-finding malpractice system siphons off large amounts of money from patients to lawyers and legal costs and is a deterrent to system improvement. While electronic records have the potential to improve care and lower costs through information sharing, their current implementation neither improves care nor lowers costs. If care is to be improved while costs are reduced, changes must be made in all these areas.
       
  • Addendum to Dr. Robert Stern’s Commentary Concerning an Herbal Product
           that Relieved Neuropathic Pain in Several Patients
    • Abstract: Publication date: October 2019Source: The American Journal of Medicine, Volume 132, Issue 10Author(s): Joseph S. Alpert
       
  • Acute Herbal Therapy Efficacy: A Case Report
    • Abstract: Publication date: October 2019Source: The American Journal of Medicine, Volume 132, Issue 10Author(s): Robert G. Stern
       
  • Prevention of Statin Overtreatment and Increased Patient Compliance in
           High-Cardiovascular-Risk Individuals
    • Abstract: Publication date: October 2019Source: The American Journal of Medicine, Volume 132, Issue 10Author(s): David S. Schade, S. Scott Obenshain, R. Philip Eaton
       
  • Obscured in Transparency: Health Care Quality and Hospital Price
           Disclosure
    • Abstract: Publication date: October 2019Source: The American Journal of Medicine, Volume 132, Issue 10Author(s): Michael U. Antonucci
       
  • Type 2 Myocardial Infarction and Value-Based Programs: Cutting the Supply
           in the Absence of Demand
    • Abstract: Publication date: October 2019Source: The American Journal of Medicine, Volume 132, Issue 10Author(s): Cian P. McCarthy
       
  • Syncope in the Elderly
    • Abstract: Publication date: October 2019Source: The American Journal of Medicine, Volume 132, Issue 10Author(s): Joseph S. Alpert
       
  • Case Reports in the Age of Twitter
    • Abstract: Publication date: October 2019Source: The American Journal of Medicine, Volume 132, Issue 10Author(s): Adam S. Cifu, Andrae L. Vandross, Vinay Prasad
       
  • Leisure-Time Running Reduces the Risk of Incident Type 2 Diabetes
    • Abstract: Publication date: October 2019Source: The American Journal of Medicine, Volume 132, Issue 10Author(s): Yuehan Wang, Duck-chul Lee, Angelique G. Brellenthin, Thijs M.H. Eijsvogels, Xuemei Sui, Timothy S. Church, Carl J. Lavie, Steven N. BlairAbstractObjectivesWe examined the overall association as well as the dose–response relationship between leisure-time running and incident type 2 diabetes.MethodsParticipants were 19,347 adults aged 18-100 years who were free of cardiovascular disease, cancer, and diabetes at baseline, and who received at least 2 extensive preventive medical examinations between 1974 and 2006. Running and other types of aerobic physical activity were assessed by self-reported leisure-time activities. Type 2 diabetes was defined as fasting glucose ≥ 126 mg/dL (7.0 mmol/L), physician diagnosis, or insulin use.ResultsDuring an average follow-up of 6.5 years, 1015 adults developed type 2 diabetes. Approximately 29.5% of adults participated in leisure-time running at baseline. Runners had a 28% (hazard ratio [HR] 0.72; 95% confidence interval [CI], 0.62-0.84) lower risk of developing type 2 diabetes compared with nonrunners during follow-up. The HRs (95% CIs) of type 2 diabetes were 0.98 (0.75-1.28), 0.69 (0.51-0.92), 0.62 (0.45-0.85), 0.78 (0.59-1.04), and 0.57 (0.42-0.79) across quintiles of running time (minutes/week) compared with nonrunners after adjusting for potential confounders, including levels of nonrunning aerobic physical activity. Similar dose–response relationships between running distance (miles/week), frequency (times/week), total amount (MET-minutes/week), and speed (mph) were also observed.ConclusionsParticipating in leisure-time running is associated with a lower risk of developing type 2 diabetes in adults. Consistent linear dose–response relationships were observed between various running parameters and incident type 2 diabetes, supporting the prescription of running to prevent type 2 diabetes.
       
  • Walking Speed Drives the Prognosis of Older Adults with Cardiovascular and
           Neuropsychiatric Multimorbidity
    • Abstract: Publication date: October 2019Source: The American Journal of Medicine, Volume 132, Issue 10Author(s): Davide L Vetrano, Debora Rizzuto, Amaia Calderón-Larrañaga, Graziano Onder, Anna-Karin Welmer, Chengxuan Qiu, Roberto Bernabei, Alessandra Marengoni, Laura FratiglioniAbstractBackgroundWe investigated the impact of multiple cardiovascular and neuropsychiatric diseases on all-cause and cause-specific mortality in older adults, considering their functional status.MethodsThis cohort study included 3241 participants (aged ≥ 60 years) in the Swedish National study of Aging and Care in Kungsholmen (SNAC-K). Number of cardiovascular and neuropsychiatric diseases was categorized as 0, 1, or ≥ 2. Functional impairment was defined as walking speed of
       
  • Digoxin Use and Associated Adverse Events Among Older Adults
    • Abstract: Publication date: October 2019Source: The American Journal of Medicine, Volume 132, Issue 10Author(s): Suveen Angraal, Sudhakar V. Nuti, Frederick A. Masoudi, James V. Freeman, Karthik Murugiah, Nilay D. Shah, Nihar R. Desai, Isuru Ranasinghe, Yun Wang, Harlan M. KrumholzAbstractBackgroundOver the past 2 decades, guidelines for digoxin use have changed significantly. However, little is known about the national-level trends of digoxin use, hospitalizations for toxicity, and subsequent outcomes over this time period.MethodsTo describe digoxin prescription trends, we conducted a population-level, cohort study using data from IQVIA, Inc.’s National Prescription Audit (2007-2014) for patients aged ≥ 65 years. Further, in a national cohort of Medicare fee-for-service beneficiaries aged ≥ 65 years in the United States, we assessed temporal trends of hospitalizations associated with digoxin toxicity and the outcomes of these hospitalizations between 1999 and 2013.ResultsFrom 2007 through 2014, the number of digoxin prescriptions dispensed decreased by 46.4%; from 8,099,856 to 4,343,735. From 1999 through 2013, the rate of hospitalizations with a principal or secondary diagnosis of digoxin toxicity decreased from 15 to 2 per 100,000 person-years among Medicare fee-for-service beneficiaries. In-hospital and 30-day mortality rates associated with hospitalization for digoxin toxicity decreased significantly among Medicare fee-for-service beneficiaries; from 6.0% (95% confidence interval [CI], 5.2-6.8) to 3.7% (95% CI, 2.2-5.7) and from 14.0% (95% CI, 13.0-15.2) to 10.1% (95% CI, 7.6-13.0), respectively. Rates of 30-day readmission for digoxin toxicity decreased from 23.5% (95% CI, 22.1-24.9) in 1999 to 21.7% (95% CI, 18.0-25.4) in 2013 (P < .05).ConclusionWhile digoxin prescriptions have decreased, it is still widely prescribed. However, the rate of hospitalizations for digoxin toxicity and adverse outcomes associated with these hospitalizations have decreased. These findings reflect the changing clinical practice of digoxin use, aligned with the changes in clinical guidelines.
       
 
 
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