for Journals by Title or ISSN
for Articles by Keywords
help
  Subjects -> MEDICAL SCIENCES (Total: 8017 journals)
    - ALLERGOLOGY AND IMMUNOLOGY (204 journals)
    - ANAESTHESIOLOGY (113 journals)
    - CARDIOVASCULAR DISEASES (322 journals)
    - CHIROPRACTIC, HOMEOPATHY, OSTEOPATHY (21 journals)
    - COMMUNICABLE DISEASES, EPIDEMIOLOGY (219 journals)
    - DENTISTRY (275 journals)
    - DERMATOLOGY AND VENEREOLOGY (158 journals)
    - EMERGENCY AND INTENSIVE CRITICAL CARE (115 journals)
    - ENDOCRINOLOGY (142 journals)
    - FORENSIC SCIENCES (39 journals)
    - GASTROENTEROLOGY AND HEPATOLOGY (175 journals)
    - GERONTOLOGY AND GERIATRICS (131 journals)
    - HEMATOLOGY (149 journals)
    - HYPNOSIS (4 journals)
    - INTERNAL MEDICINE (157 journals)
    - LABORATORY AND EXPERIMENTAL MEDICINE (96 journals)
    - MEDICAL GENETICS (59 journals)
    - MEDICAL SCIENCES (2122 journals)
    - NURSES AND NURSING (329 journals)
    - OBSTETRICS AND GYNECOLOGY (191 journals)
    - ONCOLOGY (369 journals)
    - OPHTHALMOLOGY AND OPTOMETRY (130 journals)
    - ORTHOPEDICS AND TRAUMATOLOGY (160 journals)
    - OTORHINOLARYNGOLOGY (82 journals)
    - PATHOLOGY (98 journals)
    - PEDIATRICS (262 journals)
    - PHYSICAL MEDICINE AND REHABILITATION (151 journals)
    - PSYCHIATRY AND NEUROLOGY (790 journals)
    - RADIOLOGY AND NUCLEAR MEDICINE (186 journals)
    - RESPIRATORY DISEASES (98 journals)
    - RHEUMATOLOGY (71 journals)
    - SPORTS MEDICINE (74 journals)
    - SURGERY (379 journals)
    - UROLOGY, NEPHROLOGY AND ANDROLOGY (146 journals)

MEDICAL SCIENCES (2122 journals)                  1 2 3 4 5 6 7 8 | Last

Showing 1 - 200 of 3562 Journals sorted alphabetically
16 de Abril     Open Access  
3D Printing in Medicine     Open Access   (Followers: 2)
AADE in Practice     Hybrid Journal   (Followers: 5)
ABCS Health Sciences     Open Access   (Followers: 4)
Abia State University Medical Students' Association Journal     Full-text available via subscription  
ACIMED     Open Access   (Followers: 1)
ACS Medicinal Chemistry Letters     Hybrid Journal   (Followers: 44)
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 Informatica Medica     Open Access   (Followers: 1)
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: 1)
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: 8)
Adıyaman Üniversitesi Sağlık Bilimleri Dergisi / Health Sciences Journal of Adıyaman University     Open Access  
Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi     Open Access  
Advanced Biomedical Research     Open Access  
Advanced Health Care Technologies     Open Access   (Followers: 4)
Advanced Science, Engineering and Medicine     Partially Free   (Followers: 8)
Advances in Bioscience and Clinical Medicine     Open Access   (Followers: 6)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 26)
Advances in Life Course Research     Hybrid Journal   (Followers: 8)
Advances in Lipobiology     Full-text available via subscription   (Followers: 1)
Advances in Medical Education and Practice     Open Access   (Followers: 29)
Advances in Medical Ethics     Open Access  
Advances in Medical Research     Open Access  
Advances in Medical Sciences     Hybrid Journal   (Followers: 7)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 5)
Advances in Medicine     Open Access   (Followers: 3)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 4)
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: 5)
Advances in Wound Care     Hybrid Journal   (Followers: 11)
Aerospace Medicine and Human Performance     Full-text available via subscription   (Followers: 12)
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: 2)
African Journal of Laboratory Medicine     Open Access   (Followers: 2)
African Journal of Medical and Health Sciences     Open Access   (Followers: 2)
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 Primary Research     Partially Free   (Followers: 3)
AJSP: Reviews & Reports     Hybrid Journal  
Aktuelle Ernährungsmedizin     Hybrid Journal   (Followers: 4)
Al-Azhar Assiut Medical Journal     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: 3)
Althea Medical Journal     Open Access  
American Journal of Biomedical Engineering     Open Access   (Followers: 13)
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: 7)
American Journal of Family Therapy     Hybrid Journal   (Followers: 11)
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: 11)
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: 48)
American Journal of Medicine and Medical Sciences     Open Access   (Followers: 1)
American Journal of Medicine Studies     Open Access   (Followers: 1)
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: 9)
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: 1)
Anatomy Research International     Open Access   (Followers: 2)
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 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: 2)
Annals of Bioanthropology     Open Access   (Followers: 4)
Annals of Biomedical Engineering     Hybrid Journal   (Followers: 17)
Annals of Biomedical Sciences     Full-text available via subscription   (Followers: 3)
Annals of Clinical Hypertension     Open Access  
Annals of Clinical Microbiology and Antimicrobials     Open Access   (Followers: 12)
Annals of Family Medicine     Open Access   (Followers: 14)
Annals of Health Research     Open Access  
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: 11)
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: 16)
Anthropological Review     Open Access   (Followers: 23)
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: 3)
Applied Clinical Research, Clinical Trials and Regulatory Affairs     Hybrid Journal  
Applied Medical Informatics     Open Access   (Followers: 12)
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: 3)
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     Full-text available via subscription   (Followers: 15)
Arterial Hypertension     Open Access   (Followers: 1)
Artificial Intelligence in Medicine     Hybrid Journal   (Followers: 14)
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: 11)
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: 1)
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  
Australian Coeliac     Full-text available via subscription   (Followers: 1)
Australian Family Physician     Full-text available via subscription   (Followers: 3)
Australian Journal of Medical Science     Full-text available via subscription   (Followers: 1)
Autopsy and Case Reports     Open Access  
Avicenna     Open Access   (Followers: 3)
Avicenna Journal of Clinical Medicine     Open Access  
Avicenna Journal of Medicine     Open Access   (Followers: 1)
Bangabandhu Sheikh Mujib Medical University Journal     Open Access   (Followers: 1)

        1 2 3 4 5 6 7 8 | Last

Similar Journals
Journal Cover
American Journal of Medicine
Number of Followers: 48  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0002-9343 - ISSN (Online) 1555-7162
Published by Elsevier Homepage  [3161 journals]
  • Syncope in the elderly
    • Abstract: Publication date: Available online 18 May 2019Source: The American Journal of MedicineAuthor(s): Joseph S. Alpert
       
  • The Effects of Dairy Consumption on Blood Pressure and Risk of
           Hypertension
    • Abstract: Publication date: Available online 17 May 2019Source: The American Journal of MedicineAuthor(s): Massimo Leggio, Cristina Tiberti, Massimo Armeni, Giorgio Limongelli, Andrea Mazza
       
  • The Great Masquerador: A young female with Multiple Endocrine Neoplasia
           Type 2A and bilateral pheochromocytomas
    • Abstract: Publication date: Available online 17 May 2019Source: The American Journal of MedicineAuthor(s): Chua Wei Jie Marvin, Kathleen Su-Yen Sek, Tai E Shyong
       
  • Laying Hands on the Unstable Patient: Bedside Diagnosis in Medical
           Emergencies
    • Abstract: Publication date: Available online 17 May 2019Source: The American Journal of MedicineAuthor(s): Michael Y. Lin, Mukund Ramkumar, John F. Kugler
       
  • Brief observation: Prostate artery embolization in patients with acute
           urinary retention
    • Abstract: Publication date: Available online 17 May 2019Source: The American Journal of MedicineAuthor(s): Alberto G Kenny, Olivier Pellerin, Gregory Amouyal, François Desgranchamps, M.D Paul Méria, M.D Amaury De Gouvello, M.D Charles Darianne, Carole Déan, Helena Pereira, Nicolas Thiounn, Marc Sapoval ObjectiveThe objective of this prospective study was to assess the efficacy of prostate artery embolization after failure of a trial without catheter in patients suffering a first episode of acute urinary retention due to benign prostatic hyperplasia.MethodsPatients with failure of a trial without catheter despite alpha-blocker therapy were invited to participate to this protocol. Twenty consecutive patients were included in the study. All patients underwent prostate artery embolization with calibrated PVA microspheres (Bead Block®, BTG Ltd., Farnham, UK).ResultsSuccessful removal of the indwelling bladder catheter and spontaneous voiding was achieved in 15/20 (75%) patients and the overall clinical success at 6 months after prostate embolization was 14/20 (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 his place in this setting.
       
  • Bony bump of the oral cavity
    • Abstract: Publication date: Available online 17 May 2019Source: The American Journal of MedicineAuthor(s): Sarah Soon Khe Wei, Ranjeet Bapat, Tanay Chaubal
       
  • Leisure-Time Running Reduces the Risk of Incident Type 2 Diabetes
    • Abstract: Publication date: Available online 17 May 2019Source: The American Journal of MedicineAuthor(s): Yuehan Wang, Duck-chul Lee, Angelique G. Brellenthin, Thijs M.H. Eijsvogels, Xuemei Sui, Timothy S. Church, Carl J. Lavie, Steven N. Blair ObjectivesWe 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 two 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 non-runners 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 non-runners after adjusting for potential confounders, including levels of non-running 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.
       
  • Words Matter: Removing the Word Pimp from Medical Education
           Discourse
    • Abstract: Publication date: Available online 17 May 2019Source: The American Journal of MedicineAuthor(s): Amulya Nagarur, John W. McEvoy, David A. Hirsh, Benjamin C. James
       
  • A case report of afebrile malaria
    • Abstract: Publication date: Available online 15 May 2019Source: The American Journal of MedicineAuthor(s): Nima Madanchi, Rukma Govindu, Hussam Ammar
       
  • Severe metastatic pulmonary calcification
    • Abstract: Publication date: Available online 15 May 2019Source: The American Journal of MedicineAuthor(s): Masaya Taniwaki, Kazuma Kawamoto, Masahiro Yamasaki, M.D Kunihiko Funaishi, M.D Yu Matsumoto, M.D Naoko Matsumoto, Nobuyuki Ohashi, Noboru Hattori
       
  • A Challenge is Brewing: false-positive urine alcohol in an elderly
           diabetic male.
    • Abstract: Publication date: Available online 14 May 2019Source: The American Journal of MedicineAuthor(s): Saif M Borgan, Kirolus Sourial, Ernesto Robalino Gonzaga, Kathlyn Camargo Macias, Minh Ho
       
  • Eosinophilic granulomatosis with polyangiitis: histopathological
           confirmation despite negative serology
    • Abstract: Publication date: Available online 14 May 2019Source: The American Journal of MedicineAuthor(s): Anusha M. Kumar, Gordon H. Bae, Justin Besen, Bernice Y. Kwong, Kerri E. Rieger
       
  • Don't trip over the trop – an unusual presentation of thyrotoxic
           periodic paralysis
    • Abstract: Publication date: Available online 9 May 2019Source: The American Journal of MedicineAuthor(s): Norildin Al-Refaie, Shweta Appiah, Amit K J Mandal, Constantinos G Missouris
       
  • Fish Oil And Cardiometabolic Diseases: Recent Updates And Controversies
    • Abstract: Publication date: Available online 8 May 2019Source: The American Journal of MedicineAuthor(s): Ramyashree Tummala, Raktim Kumar Ghosh, Vardhmaan Jain, Arvind Reddy Devanabanda, Dhrubajyoti Bandyopadhay, Praksash Deedwania, Wilbert S. Aronow Fatty 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 acid supplements and their benefits on cardiovascular health. The more recent trials including the JELIS, REDUCE-IT, VITAL, STRENGTH, and the ASCEND trials addressed the paucity of data of omega-3 Fatty acids on primary as well as secondary prevention of cardiovascular events and 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, the REDUCE-IT study showed a possible protective benefit of fish oil supplements (in purified form and higher than normal doses) in the reduction of Triglyceride levels. It is also noteworthy that omega-3 fatty acids have found their mention in the most recent American College of Cardiology guidelines for the management of hypertriglyceridemia as an adjunct to statins and fibrates. The aim of this review is to discuss these recent updates on use of fish oil in cardiometabolic diseases, and their surrounding controversies.
       
  • Presumed Pancreatitis in the Setting of Renal Impairment
    • Abstract: Publication date: May 2019Source: The American Journal of Medicine, Volume 132, Issue 5Author(s): Muhammad Khan, Abdurraoof Patel, Reza Samad
       
  • Recurrent Abdominal Pain in Systemic Lupus Erythematosus: Concurrent Lupus
           Enteritis and Lupus Cystitis
    • Abstract: Publication date: May 2019Source: The American Journal of Medicine, Volume 132, Issue 5Author(s): Pablo Andrés Castaño-González, Luis Alonso González
       
  • More Martial than Arts: Coronary Artery Dissection after Chest Kick
    • Abstract: Publication date: May 2019Source: The American Journal of Medicine, Volume 132, Issue 5Author(s): Markus Linhart, Walter Bragagnini, Ander Regueiro, Eduardo Flores, Guiomar Mendieta, Antonio Martínez-Rubio
       
  • Short-TErm Psychotherapy IN Acute Myocardial Infarction (STEP-IN-AMI)
           Trial: Final Results
    • Abstract: Publication date: May 2019Source: The American Journal of Medicine, Volume 132, Issue 5Author(s): Christian Pristipino, Adriana Roncella, Vincenzo Pasceri, Giulio Speciale PurposeThe purpose of this research was to assess whether short-term psychotherapy enhances long-term clinical outcomes in patients with a recent acute myocardial infarction (AMI).MethodsPatients ≤70 years old were randomized within 1 week of their AMI to short-term ontopsychological psychotherapy plus routine medical therapy vs routine medical therapy only. The primary composite outcome was defined as the combined incidence of new cardiovascular events (re-infarction, death, stroke, revascularization, life-threatening ventricular arrhythmias, and the recurrence of clinically significant angina) and clinically significant new comorbidities. Secondary outcome measures were: rates for individual components of the primary composite outcome; the rate of re-hospitalization for cardiovascular problems; and New York Heart Association functional class.ResultsNinety-four patients were analyzed, translating into 425 patient-years. The 2 treatment groups were similar across baseline characteristics. At 5-year follow-up, psychotherapy patients had a lower incidence of primary outcome, relative to controls (77/223 vs 98/202 patient-years, respectively; P = .035; absolute risk reduction = 19%, number needed to treat = 8); this benefit was attributable to the lower incidence of new comorbidities and clinically significant angina in the psychotherapy group. Gains in the primary outcome, relative to controls, among psychotherapy patients occurred in the first year and subsequently remained stable over the following 4 years.ConclusionsAdding short-term ontopsychological psychotherapy to routine secondary prevention of myocardial infarction improves clinical outcomes overall up to 5 years post AMI. Studying time trends may aid in better targeting of psychological interventions during follow-up. Larger studies remain necessary to confirm these results.Trial registrationwww.ClinicalTrial.gov NCT00769366
       
  • TUSARC: Prognostic Value of High-Sensitivity Cardiac Troponin T Assay in
           Asymptomatic Patients with High Cardiovascular Risk
    • Abstract: Publication date: May 2019Source: The American Journal of Medicine, Volume 132, Issue 5Author(s): Diego Martín Raymondi, Héctor Garcia, Isabel Álvarez, Luis Hernández, Jorge Palazuelos Molinero, Vicente Villamandos BackgroundPrognostic value of high-sensitivity cardiac troponin T (hs-cTnT) assays have been assessed in selected populations in different studies and in registries of members of the general population with low cardiovascular risk. The aim of this study was to determine the prognostic value of hs-cTnT in an asymptomatic very-high cardiovascular risk Spanish population.MethodsFrom a previous prospective cohort of the TUSARC (troponina T UltraSensible en pacientes Asintomáticos de alto Riesgo Cardiovascular) registry, follow-up was conducted in 602 patients (93.18%). The association of high hs-cTnT (≥99th percentile value) and incidence of primary event was studied. A primary event was defined as a combined major cardiovascular event (incidence of cardiovascular death, decompensated heart failure, non-fatal cerebrovascular event, non-fatal myocardial infarction, or coronary revascularization). The association between high hs-cTnT and incidence of secondary events was studied as well.ResultsIn patients with high hs-cTnT, the incidence of primary event during follow-up was significantly higher (18.30% vs 3.67% P < .001): heart failure (6.25% vs 0.73% P < .001), cardiovascular death (7.29% vs 0.00% P < .001), and death from any cause (7.81% vs 0.98% P < .001).ConclusionsIn an asymptomatic very-high cardiovascular risk Spanish population, elevated hs-cTnT was significantly associated with incident major cardiovascular combined end point and incidence of heart failure, cardiovascular death, and death from any cause.
       
  • Clinical Features and Prognosis of Patients with Acute and Chronic
           Myocardial Injury Admitted to the Emergency Department
    • Abstract: Publication date: May 2019Source: The American Journal of Medicine, Volume 132, Issue 5Author(s): Alfredo Bardají, Gil Bonet, Anna Carrasquer, Maribel González-del Hoyo, Karla Vásquez-Nuñez, Samuel Ali, Carme Boqué, Germán Cediel BackgroundThis study aimed to investigate the clinical features and prognosis of acute and chronic myocardial injury without clinical evidence of myocardial infarction in patients admitted to the emergency department.MethodsWe analyzed the clinical data of all consecutive patients admitted to the emergency department during the years 2012 and 2013 who had at least 2 determinations of troponin I (TnI Ultra Siemens, Advia Centaur) and without a diagnosis of myocardial infarction. Clinical events were evaluated in a 3-year follow-up.ResultsA total of 1201 patients met the study's inclusion criteria and were included in the analysis (833 with cTnI below the 99th percentile, 261 with acute myocardial injury, and 107 with chronic myocardial injury). During a median follow-up of more than 36 months, mortality and rehospitalization for heart failure were significantly higher in patients with acute or chronic myocardial injury compared with patients without myocardial injury. No differences were observed in overall mortality between patients with acute and chronic myocardial injury, or in the rate of readmission due to acute coronary syndrome. However, the risk of readmission due to heart failure (adjusted HR 2.17; 95% confidence interval, 1.26-3.75; P = .005) was higher in patients with chronic myocardial injury.ConclusionsMortality in long-term follow-up is high and similar in acute and chronic myocardial injury; however, the risk of readmission due to heart failure is higher in patients with chronic myocardial injury compared with patients with acute myocardial injury.
       
  • Young Adults and Adverse Childhood Events: A Potent Measure of
           Cardiovascular Risk
    • Abstract: Publication date: May 2019Source: The American Journal of Medicine, Volume 132, Issue 5Author(s): Catherine Kreatsoulas, Eric W. Fleegler, Laura D Kubzansky, Catherine M. McGorrian, Subu V. Subramanian IntroductionWhile cardiovascular disease is the leading cause of death, its determinants include unhealthy behaviors and clinical risk factors and are recognized as the “actual causes” of death. Risk likely accumulates over the life course, and adverse childhood experiences may increase the risk of “actual causes” of death. The objectives of the study are to determine the prevalence and test the association of adverse childhood experiences among unhealthy behaviors and risk factors as a primordial risk factor among young adults.MethodsData were extracted from the 2009 and 2011 Behavioural Risk Factor Surveillance System. Individuals ages 18-99 years provided complete information on adverse childhood experiences, health behaviors, and risk factors. Adverse childhood experiences were categorized and evaluated as cumulative burden. Multivariable logistic models, including stratified analysis for young adults, tested the association of adverse childhood experiences burden with unhealthy behaviors and risk factors.ResultsAmong 45,482 study participants, 52% report one adverse childhood experience and 25% report 2 adverse childhood experience categories. Among the total study population, 37% report violence/emotional abuse, 34% report neglect, and 12% report sexual abuse. Even one adverse childhood experience is strongly associated with hypertension, dyslipidemia, and diabetes, and while the association increases in a dose-response (P trend < .001) for all, it is especially more pronounced among the younger adults, with minimal attenuation of effects in the fully adjusted models.ConclusionThe prevalence of adverse childhood experiences in this study population is high. Even one adverse childhood experience is strongly and independently associated with cardiovascular risk factors, with implications for primordial prevention. Future studies are needed to develop screening and treatment strategies targeted to this high-risk group, especially among young adults.
       
  • A Curious Case of Transient Movement Disorder
    • Abstract: Publication date: May 2019Source: The American Journal of Medicine, Volume 132, Issue 5Author(s): Katie Newton Kennedy, Yunan Darien Wang
       
  • Pruritic Plaque on the Arm After Treatment for Neurosyphilis
    • Abstract: Publication date: May 2019Source: The American Journal of Medicine, Volume 132, Issue 5Author(s): Erika Sawka, Erin Foster, Teri M. Greiling
       
  • Challenging to Treat: Fluctuating Abdominal and Joint Pain and Rash
    • Abstract: Publication date: May 2019Source: The American Journal of Medicine, Volume 132, Issue 5Author(s): Katherine L. Allen, Eric J. Dein, Osama M.E. Ali, Allan C. Gelber
       
  • Giant Cell Arteritis Presenting with a Tongue Lesion
    • Abstract: Publication date: May 2019Source: The American Journal of Medicine, Volume 132, Issue 5Author(s): George Cockey, Syed Raza Shah, Troy Hampton
       
  • The State of Ambulatory Undergraduate Internal Medicine Medical Education:
           Results of the 2016 Clerkship Directors in Internal Medicine Annual Survey
           
    • Abstract: Publication date: May 2019Source: The American Journal of Medicine, Volume 132, Issue 5Author(s): Amy W. Shaheen, Irene Alexandraki, S.B. Fazio, Margaret C. Lo, Clifford D. Packer, Harish Jasti, Michael Kisielewski, Susan T. Hingle
       
  • Significance of Obstetrical History with Future Cardiovascular Disease
           Risk
    • Abstract: Publication date: May 2019Source: The American Journal of Medicine, Volume 132, Issue 5Author(s): Emmanuel Bassily, Cameron Bell, Sean Verma, Nidhi Patel, Aarti Patel The maternal cardiovascular system undergoes profound changes to support the increasing demands of fetal growth during pregnancy. An accumulating body of evidence has shown that common pregnancy complications, including gestational diabetes mellitus, preeclampsia, low birth weight, and preterm delivery, can be associated with future cardiovascular adverse events in mothers. Factors such as glucose metabolism, hyperlipidemia, inflammatory markers, and large- and small-vessel stiffness/functionality have been linked with these pregnancy conditions. Critically, there are no established guidelines to account for these maternal factors when considering future cardiovascular disease risk, one of the leading causes of female mortality. This article reviews the study of cardiovascular disease and pregnancy, and proposes possible connections that should spur future investigation in an area of medicine that requires significant research.
       
  • Ten Secrets to a Long Life
    • Abstract: Publication date: May 2019Source: The American Journal of Medicine, Volume 132, Issue 5Author(s): William H. Frishman For centuries there has been an ongoing search to identify the secrets of long life and healthy aging. Recently, multiple factors have been identified, including genetics, the introduction of antibiotics, vaccines, and public health, effective management of cardiovascular risk factors, advances in surgery, eliminating or modifying high-risk behaviors, family and social supports, eliminating wars and poverty, luck, exercise and nutrition, and psychological factors such as optimism and conscientiousness. To increase a maximum life span now estimated to be 115-120 years will involve manipulation of genes and the body's stem cells and the potential use of senolytic drugs (that kill old cells), which will need to be investigated. This is a worthy pursuit if these interventions will also maintain or enhance quality of life.
       
  • Beyond Burnout: A Physician Wellness Hierarchy Designed to Prioritize
           Interventions at the Systems Level
    • Abstract: Publication date: May 2019Source: The American Journal of Medicine, Volume 132, Issue 5Author(s): Daniel E. Shapiro, Cathy Duquette, Lisa M. Abbott, Timothy Babineau, Amanda Pearl, Paul Haidet Burnout has been implicated in higher physician turnover, reduced patient satisfaction, and worsened safety, but understanding the degree of burnout in a given physician or team does not direct leaders to solutions. The model proposed integrates a long list of variables that may ameliorate burnout into a prioritized, easy-to-understand hierarchy. Modified from Maslow's hierarchy, the model directs leaders to address physicians’ basic physical and mental health needs first; patient and physician physical safety second; and then address higher-order needs, including respect from colleagues, patients, processes, and the electronic health record; appreciation and connection; and finally, time and resources to heal patients and contribute to the greater good. Assessments based on this model will help leaders prioritize interventions and improve physician wellness.
       
  • Physician Compensation Methodology Must Change!
    • Abstract: Publication date: May 2019Source: The American Journal of Medicine, Volume 132, Issue 5Author(s): Morey Menacker
       
  • The Ego Has Landed! What Can Be Done About Research Misconduct, Scandals,
           and Spins'
    • Abstract: Publication date: May 2019Source: The American Journal of Medicine, Volume 132, Issue 5Author(s): David R. Thompson, Alexander M. Clark
       
  • Building Trust in the Profession: What Can We Learn from Choosing
           Wisely'
    • Abstract: Publication date: May 2019Source: The American Journal of Medicine, Volume 132, Issue 5Author(s): Richard J. Baron, Daniel B. Wolfson
       
  • In a Critical State: Ongoing Barriers to Treatment for Hepatitis C Virus
           (HCV)
    • Abstract: Publication date: May 2019Source: The American Journal of Medicine, Volume 132, Issue 5Author(s): Jorge Mera, Brigg Reilley, Jessica Leston, David Stephens
       
  • So, You Have to Give a Lecture—Are You Anxious'
    • Abstract: Publication date: May 2019Source: The American Journal of Medicine, Volume 132, Issue 5Author(s): Joseph S. Alpert
       
  • The Rheumatoid Hands of Renoir
    • Abstract: Publication date: May 2019Source: The American Journal of Medicine, Volume 132, Issue 5Author(s): Jagdeep Singh Gandhi
       
  • Take It From Sammy
    • Abstract: Publication date: May 2019Source: The American Journal of Medicine, Volume 132, Issue 5Author(s): David B. Hellmann
       
  • Demographic, Clinical, and Radiologic Characteristics of a Cohort of
           Patients with Takayasu Arteritis
    • Abstract: Publication date: May 2019Source: The American Journal of Medicine, Volume 132, Issue 5Author(s): Catalina Sanchez-Alvarez, Lester E. Mertz, Colleen S. Thomas, Jordan J. Cochuyt, Andy AbrilABSTRACTBackgroundTakayasu arteritis is a rare large-vessel vasculitis that predominantly affects females of Asian descent. This retrospective analysis was performed to increase understanding of the epidemiology of the disease in the United States.MethodsWe performed a retrospective cohort study in 2 tertiary centers. Patients were selected according to the American College of Rheumatology classification criteria for Takayasu arteritis. Data collected included demographic characteristics and details of physical examinations, treatments, and surgical interventions. Data were managed with REDCap (Research Electronic Data Capture) tools.ResultsThe study included 57 patients. The female:male ratio was 4.2:1, the median age at diagnosis was 29 years, 61.4% of the patients were Caucasians, and 86% of the patients had stenosis on imaging. Hata V was the most common angiographic classification (37.5% of patients). Vascular interventions were required in 43.9% of patients. The most frequent complications were hypertension (56.1%), renal artery stenosis (28.1%), and aortic insufficiency (19.3%).ConclusionsTakayasu arteritis continues to be a rare large-vessel vasculitis. In the United States, it tends to affect predominantly Caucasian females, with cervicobrachial involvement. This cohort reflects the morbidity, multiple interventions, and complications experienced by patients with Takayasu arteritis.
       
  • The Reply
    • Abstract: Publication date: May 2019Source: The American Journal of Medicine, Volume 132, Issue 5Author(s): Matteo Coen, Karim Bendjelid
       
  • Pulmonary Embolism in the Differential Diagnosis of Cardiovocal Syndrome
    • Abstract: Publication date: May 2019Source: The American Journal of Medicine, Volume 132, Issue 5Author(s): Oscar M.P. Jolobe
       
  • The Reply
    • Abstract: Publication date: May 2019Source: The American Journal of Medicine, Volume 132, Issue 5Author(s): Anna Gu, Edgar Argulian
       
  • Cardiorespiratory Fitness in Healthy People: A Step Forward to Primary
           Cardiovascular Health Promotion
    • Abstract: Publication date: May 2019Source: The American Journal of Medicine, Volume 132, Issue 5Author(s): Massimo Leggio, Cristina Tiberti, Giorgio Limongelli, Andrea Mazza
       
  • Pneumocystis Pneumonia Complicated by Extensive Diffuse
           Pneumatoceles
    • Abstract: Publication date: May 2019Source: The American Journal of Medicine, Volume 132, Issue 5Author(s): Hasan Ahmad Hasan Albitar, Omar M. Abu Saleh
       
  • Diffuse Vascular FDG Uptake in Late Onset Takayasu Arteritis
    • Abstract: Publication date: May 2019Source: The American Journal of Medicine, Volume 132, Issue 5Author(s): Ko Harada, Kou Hasegawa, Fumio Otsuka
       
  • Plecanatide for Treatment of Chronic Constipation and Irritable Bowel
           Syndrome
    • Abstract: Publication date: May 2019Source: The American Journal of Medicine, Volume 132, Issue 5Author(s): Bryan L. Love Chronic idiopathic constipation and irritable bowel syndrome with constipation are commonly encountered in ambulatory patients, but limited options exist for patients with persistent or severe symptoms following treatment with nonprescription products. Plecanatide (Trulance, Synergy Pharmaceuticals, New York, NY) is a 16-amino acid peptide analog of uroguanylin that stimulates guanylate cyclase-C receptors to increase chloride and bicarbonate secretion into the intestine and prevents the absorption of sodium ions, thereby increasing the secretion of water into the lumen. The influx of additional fluid accelerates intestinal transit, softens the stool, and facilitates easier defecation. Plecanatide is the second guanylate cyclase-C receptor agonist to be approved by the US Food and Drug Administration for chronic idiopathic constipation and irritable bowel syndrome, but plecanatide is unique because its effects are limited to the proximal small bowel.
       
  • Keeping a Low Profile: Insulinoma
    • Abstract: Publication date: Available online 3 May 2019Source: The American Journal of MedicineAuthor(s): Ramzi Dudum, Vivek K. Murthy
       
  • Uncovering the secret hidden beneath a failing memory
    • Abstract: Publication date: Available online 2 May 2019Source: The American Journal of MedicineAuthor(s): Preetha Venugopalan Menon, Tan Li Feng, Santhosh Kumar Seetharaman
       
  • Conflicts of interest: None - A Benign Invasive Procedure: The
           Biopsychosocial Biopsy
    • Abstract: Publication date: Available online 2 May 2019Source: The American Journal of MedicineAuthor(s): Michael W. Kahn
       
  • Oh Deer! A Case of Fever and Myalgia in a Liver Transplant Recipient
    • Abstract: Publication date: Available online 1 May 2019Source: The American Journal of MedicineAuthor(s): Hasan Ahmad Hasan Albitar, Pooja R. Gurram, Zerelda Esquer Garrigos, M. Rizwan Sohail
       
  • Are e-cigarettes the answer' A novel case of methemoglobinemia
    • Abstract: Publication date: Available online 1 May 2019Source: The American Journal of MedicineAuthor(s): Patrick Twohig, Jaclyn Rivington, William Cook
       
  • Reactive, Holistic, Proactive: Practical Applications of the AAIM Learning
           and Working Environment Conceptual Model
    • Abstract: Publication date: Available online 1 May 2019Source: The American Journal of MedicineAuthor(s): Rebecca C Jaffe, Christina R Bergin, Lawrence K Loo, Simran Singh, Brian Uthlaut, Susan A Glod, Emily Fondhan, Alyssa McManamon, Sara L Wallach, Karen Hamad, Katherine Walsh, Bethany Gentilesco
       
  • Have you ever seen a LEOPARD'
    • Abstract: Publication date: Available online 30 April 2019Source: The American Journal of MedicineAuthor(s): Lucien Marchand
       
  • Prognostic significance of longitudinal clinical congestion pattern in
           chronic heart failure: insights from TIME-CHF trial
    • Abstract: Publication date: Available online 30 April 2019Source: The American Journal of MedicineAuthor(s): Justas Simonavičius, Sandra Sanders van-Wijk, Peter Rickenbacher, Micha T. Maeder, Otmar Pfister, Beat A. Kaufmann, Matthias Pfisterer, Jelena Čelutkienė, Roma Puronaitė, Christian Knackstedt, Vanessa van Empel, Hans-Peter Brunner-La Rocca BackgroundThe relationship between longitudinal clinical congestion pattern and heart failure outcome is uncertain. This study was designed to assess the prevalence of congestion over time and to investigate its impact on outcome in chronic heart failure.MethodsA total of 588 chronic heart failure patients ≥ 60 years with New York Heart Association (NYHA) functional class ≥ II from the TIME-CHF study were included. The endpoints for this study were survival and heart failure hospitalization-free survival. Orthopnea, NYHA ≥ III, paroxysmal nocturnal dyspnea, hepatomegaly, peripheral pitting edema, jugular venous distension and rales were repeatedly investigated and related to outcomes. These congestion-related signs/symptoms were used to design a 7 item Clinical Congestion Index.ResultsSixty-one percent of patients had a Clinical Congestion Index ≥ 3 at baseline, which decrease to 18% at month 18. During the median [interquartile range] follow-up of 27.2 [14.3–39.8] months, 17%, 27%, and 47% of patients with baseline Clinical Congestion Index of 0, 1–2, and ≥ 3 at inclusion, respectively, died (p 
       
  • The Purpose of the Medical Record: Why Lawrence Weed Still Matters
    • Abstract: Publication date: Available online 30 April 2019Source: The American Journal of MedicineAuthor(s): Mark D. Aronson
       
  • Bias in Medicine
    • Abstract: Publication date: Available online 30 April 2019Source: The American Journal of MedicineAuthor(s): Joseph S. Alpert
       
  • Massive Pulmonary Artery Dilatation in a Case of Chronic Thromboembolic
           Pulmonary Hypertension
    • Abstract: Publication date: Available online 30 April 2019Source: The American Journal of MedicineAuthor(s): Jeremy A Miles, Ningxin Wan, Sandhya Murthy
       
  • Mercury poisoning presenting with hypertension: report of two cases
    • Abstract: Publication date: Available online 30 April 2019Source: The American Journal of MedicineAuthor(s): Jin Yan, Yujie Pan, Ziren Tang, Yuguo Song BackgroundMercury poisoning can cause damage to multiple organs. Secondary hypertension, which is usually misdiagnosed and mistreated, has been rarely reported in cases of mercury poisoning.MethodsWe herein present two cases of hypertension as the main manifestation of mercury poisoning.ResultsCase 1 involved a 42-year-old man with blood pressure of 230/190 mmHg and urinary mercury level of 131.54 μmol/molCr. The patient had been repeatedly exposed to mercury at his workplace and admitted to our department many times. His hypertension quickly normalized after every chelation treatment. Case 2 involved a 10-year-old girl with hypertension (150/110 mmHg), rash, and convulsions. She was found to have elevated blood levels of renin, angiotensin II, and aldosterone as well as an elevated urinary mercury level. Her hypertension recovered soon after chelation treatment.ConclusionsMercury poisoning can cause secondary hypertension as the main clinical manifestation or together with multi-organ damage. Renin–angiotensin system activation may be involved in the occurrence and development of hypertension.
       
  • Cardiorespiratory Fitness and Health Care Costs in Diabetes: The Veterans
           Exercise Testing Study
    • Abstract: Publication date: Available online 29 April 2019Source: The American Journal of MedicineAuthor(s): Jonathan Myers, Christina Grűone de Souza de Silva, Rachelle Doom, Holly Fonda, Khin Chan, Shirit Kamil-Rosenberg, Peter Kokkinos ObjectiveTo determine the association between cardiorespiratory fitness and healthcare expenditures among individuals with and without diabetes.MethodsAs part of a prospective observational study, health care costs were quantified among 3924 consecutive men (mean age 58 ± 11 years) referred for a maximal exercise test for clinical reasons and compared according to presence (n = 2457) and absence (n = 1467) of diabetes and fitness. Fitness was classified into four categories based on age-stratified quartiles of peak metabolic equivalents: Least-fit (5.1 ± 1.5 metabolic equivalents; n = 1044), Moderately-fit (7.6 ± 1.5 metabolic equivalents; n = 938), Fit (9.4 ± 1.5 metabolic equivalents; n = 988), and Highly-fit (12.4 ± 2.2 metabolic equivalents; n = 954). Annual costs per subject were quantified over an 8 year period.ResultsAge, body mass index and presence of cardiovascular disease were similar between subjects with vs. without diabetes. After adjusting for age and presence of cardiovascular disease, annual cost per person (United States dollars 103) for each fitness quartile among individuals with diabetes vs. without diabetes were (mean ± SD): Least-fit - $59.5 ± 127.3 vs. $57.5 ± 138.2 (p = 0.04); Moderately-fit - $46.5 ± 99.8 vs. $31.3 ± 666.7 (p 
       
  • Mucormycosis: More than meets the eye!
    • Abstract: Publication date: Available online 29 April 2019Source: The American Journal of MedicineAuthor(s): Maryann T Ally, Ian H Jenkins, SFHM, Vineet Gupta, SFHM
       
  • America's Health Care System is Broken: What Went Wrong and How We Can Fix
           It. Part 4: The Pharmaceutical Industry
    • Abstract: Publication date: Available online 26 April 2019Source: The American Journal of MedicineAuthor(s): Edward P Hoffer As is true for most aspects of the US health care system, we pay much more for medications than do patients in any other country. Not only are new “breakthrough” products expensive, but existing products see price increases that regularly outstrip general inflation, making the pharmaceutical industry very profitable and resulting in many patients skipping or cutting the doses of such critical medicines as insulin. There is little relation between the effectiveness and the price of many medications. Drug firms like to cite the high cost of R + D but spend more on marketing than on R + D. The firms also spend large sums on lobbying and to influence medical thought leaders to keep their profits high. We are alone in spending $billions on pharmacy benefit managers that add little value. With new gene-based therapies on the horizon, the price of therapeutics may be unsustainable.
       
  • 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: Available online 25 April 2019Source: The American Journal of MedicineAuthor(s): Phillip J. Baker There 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 diagnosis of Lyme disease. The public health consequences of failing to consider these issues is discussed.
       
  • Hidden Janeway lesion
    • Abstract: Publication date: Available online 15 April 2019Source: The American Journal of MedicineAuthor(s): Shingo Suzuki, Hirotada Hoshino
       
  • Intravascular large B-cell lymphoma with initial presentation in skin: a
           rare mimicker of cellulitis
    • Abstract: Publication date: Available online 15 April 2019Source: The American Journal of MedicineAuthor(s): Tse-Yuan Liaw, Stephen Chu-Sung Hu
       
  • Case Reports in the Age of Twitter
    • Abstract: Publication date: Available online 15 April 2019Source: The American Journal of MedicineAuthor(s): Adam S Cifu, Andrae L Vandross, Vinay Prasad
       
  • Barriers to End-of-Life Care from Tuberculosis: A Teachable Moment
    • Abstract: Publication date: Available online 15 April 2019Source: The American Journal of MedicineAuthor(s): Justin K. Lui, Justin Peterson
       
  • Abnormal Chest Radiograph in Rapidly Progressive Glomerulonephritis –
           Not the Usual Pulmonary-Renal Syndrome
    • Abstract: Publication date: Available online 15 April 2019Source: The American Journal of MedicineAuthor(s): Jamie XL Kee, Jason CJ Choo, Angela M Takano, Syed S Ahmed, Irene YJ Mok, Cynthia C. Lim
       
  • A Paralyzing Vacation: Surfer's Myelopathy
    • Abstract: Publication date: Available online 15 April 2019Source: The American Journal of MedicineAuthor(s): Michael X. Yang, Mark J. Ault
       
  • Chronic Kidney Disease in Agricultural Communities
    • Abstract: Publication date: Available online 15 April 2019Source: The American Journal of MedicineAuthor(s): Russell A. Wilke, Mohammad Qamar, Roxana A. Lupu, Shaopeng Gu, Jing Zhao Patients residing in agricultural communities have a high risk of developing chronic kidney disease. In the Great Plains, geo-environmental risk factors (variable climate, temperature, air quality, water quality and drought) combine with agro-environmental risk factors (exposure to fertilizers, soil conditioners, herbicides, fungicides and pesticides) to increase risk for toxic nephropathy. However, research defining the specific influence of agricultural chemicals on the progression of kidney disease in rural communities has been somewhat limited. By linking retrospective clinical data within electronic medical records to environmental data from sources like EPA, analytical models are beginning to provide insight into the impact of agricultural practices on the rate of progression for kidney disease in rural communities.
       
  • Placebo and nocebo effects, medication bias, and hearsay
    • Abstract: Publication date: Available online 15 April 2019Source: The American Journal of MedicineAuthor(s): Joseph S. Alpert
       
  • A Feasible, Simple, Cost-saving Program to End Cardiovascular Disease in
           the United States
    • Abstract: Publication date: Available online 15 April 2019Source: The American Journal of MedicineAuthor(s): David S. Schade, S. Scott Obenshain, Barry Ramo, R. Philip Eaton
       
  • Exploring the bedside clinician's medical intelligence in the age of
           artificial intelligence
    • Abstract: Publication date: Available online 15 April 2019Source: The American Journal of MedicineAuthor(s): Claude Matuchansky
       
  • Discriminatory and Sexually Inappropriate Remarks from Patients and its
           Challenge to Professionalism
    • Abstract: Publication date: Available online 15 April 2019Source: The American Journal of MedicineAuthor(s): David Alfandre, Cynthia Geppert
       
  • Inappropriate testing and treatment of Factor V Leiden and other heritable
           thrombophilias
    • Abstract: Publication date: Available online 15 April 2019Source: The American Journal of MedicineAuthor(s): Scott J. Parsons, Sven R. Olson, Thomas G. DeLoughery
       
  • “A Disappearing Lung Mass: Round Pneumonia”
    • Abstract: Publication date: Available online 15 April 2019Source: The American Journal of MedicineAuthor(s): Sonali Gupta, Pradeep Goyal, Aleksandra Rosinski
       
  • Otogenic pneumocephalus presenting as pneumatocele of the scalp
    • Abstract: Publication date: Available online 15 April 2019Source: The American Journal of MedicineAuthor(s): Mercy George, Vincent Dunet, Stephen Alzuphar, Francois Borsotti, Roy Thomas Daniel, Christian Simon
       
  • Recognizing Central Nervous System Involvement As A Progressive Feature of
           Microscopic Polyangiitis: A Diagnostic Dilemma
    • Abstract: Publication date: Available online 12 April 2019Source: The American Journal of MedicineAuthor(s): Tawnya Pancharovski, Saikrishna Patibandla, Aung Naing Lin, Ying Xian Liu, Stuart Green, Sima S. Pendharkar
       
  • Is Any Patient With Chronic Heart Failure Receiving the Right Dose of the
           Right Beta-Blocker in Primary Care'
    • Abstract: Publication date: Available online 12 April 2019Source: The American Journal of MedicineAuthor(s): Milton Packer
       
  • Following the Track to an Unexpected Diagnosis: Phaeohyphomycosis
    • Abstract: Publication date: Available online 12 April 2019Source: The American Journal of MedicineAuthor(s): Arooj Mohammed, Sahand Rahnama-Moghadam
       
  • A Novel Technique to Expand the Electrocardiographic Recording Capability
           from an Apple Watch
    • Abstract: Publication date: Available online 6 April 2019Source: The American Journal of MedicineAuthor(s): Daniel R. Frisch
       
  • Prevention of Statin Overtreatment and Increased Patient Compliance in
           High Cardiovascular Risk Individuals
    • Abstract: Publication date: Available online 4 April 2019Source: The American Journal of MedicineAuthor(s): David S. Schade, S. Scott Obenshain, R. Philip Eaton
       
  • Addendum to Dr. Robert Stern's Commentary Concerning an Herbal Product
           that Relieved Neuropathic Pain in Several Patients
    • Abstract: Publication date: Available online 3 April 2019Source: The American Journal of MedicineAuthor(s): Joseph S. Alpert
       
  • Nested Domains: A Global Conceptual Model for Optimizing the Clinical
           Learning and Working Environment
    • Abstract: Publication date: Available online 3 April 2019Source: The American Journal of MedicineAuthor(s): Rebecca C Jaffe, Christina R Bergin, Lawrence K Loo, Simran Singh, Brian Uthlaut, Susan A Glod, Emily Fondhan, Alyssa McManamon, Sara L Wallach, Karen Hamad, Katherine Walsh, Bethany Gentilesco
       
  • Unconscious Woman in Shock and Covered with Ants Pulled from an Abandoned
           Automobile
    • Abstract: Publication date: Available online 3 April 2019Source: The American Journal of MedicineAuthor(s): Michael Bernaba, Emilio Power, Janet Campion, Dietrich Gotzen, Justin O. Schmidt, Stephen A. Klotz A middle-aged female was taken from an abandoned automobile unconscious and covered with ants in Tucson, AZ. When hospitalized in July 2018 she had an extensive papular-pustular skin eruption on her abdomen and thigh and disseminated intravascular coagulation (DIC). She had been stung innumerable times by native golden fire ants (Solenopsis aurea) while sleeping in the vehicle.The clinical findings of fire ant stings are presented as well as the importance of recognizing the distinctive skin lesions produced by the stings. Stings of the red imported fire ant, Solenopsis invicta and the black imported fire ant, S. richteri, cause characteristic skin lesions recognized by physicians and victims alike in the southern and southeastern United States. Native fire ant stings are documented much less often, however. Nevertheless, there is significant cross reactivity among the venoms of Solenopsis species. The large amount of venom injected by stings into this individual may have triggered DIC since the venom contains powerful hemolytic factors. Severe reactions caused by imported and native fire ant stings are infrequent, but are likely to become more common as fire ant populations expand.Case Presentation.A 52-year old woman was found unresponsive in an abandoned automobile and covered with ants. She had spilled pineapple cake in the car the day before. She was brought to the emergency room by ambulance. She had a past medical history of hepatitis C, cirrhosis, diabetes mellitus, intravenous drug abuse and chronic alcohol use. When last seen by a friend the evening before admission, she was feeling well. In the emergency department she was unconscious with a temperature of 102 °F, pulse of 111 beats/min; a blood pressure of 71/44 mmHg and a respiratory rate of 22 breathes/min. Her oral pharynx was normal; there was no wheezing on auscultation of the chest and no signs of bleeding; the fecal occult blood test was negative. There were small erythematous papules on her lower left abdomen and left upper thigh (Fig. 1). Initial laboratory results showed a hemoglobin of 3 g/dL (normal 12.1–15.1/dL); platelet count of 47,000/mm3 (normal 150–450,000/mm3); elevated PT 33.7 s (normal 11–13.5 s), INR 2.94 (normal 0.8–1.1); APTT 44.5 s (normal 30–40 s), and a low fibrinogen of 95 mg/dL (normal 150–400 mg/dL). The total bilirubin was 7.7 mg/dL (normal 0.1–1.2 mg/dL) on admission and increased to 10.0 mg/dL the following day. The direct bilirubin was 4.2 mg/dL on admission (normal 0–0.4 mg/dL). Haptoglobin was  20 (normal
       
  • Reactive perforating collagenosis in end stage renal disease: Not all that
           itches is uremic pruritis!
    • Abstract: Publication date: Available online 3 April 2019Source: The American Journal of MedicineAuthor(s): Harini Bejjanki, Alan E. Siroy, Abhilash Koratala
       
 
 
JournalTOCs
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
Email: journaltocs@hw.ac.uk
Tel: +00 44 (0)131 4513762
Fax: +00 44 (0)131 4513327
 
Home (Search)
Subjects A-Z
Publishers A-Z
Customise
APIs
Your IP address: 3.208.22.127
 
About JournalTOCs
API
Help
News (blog, publications)
JournalTOCs on Twitter   JournalTOCs on Facebook

JournalTOCs © 2009-