Comparative effectiveness and safety of ticagrelor and clopidogrel in patients with or without chronic liver disease: a nationwide cohort study
Although the effectiveness and safety of ticagrelor versus clopidogrel may differ in patients with chronic liver disease, there is a scarcity of evidence comparing ticagrelor and clopidogrel in patients with chronic liver disease. We aimed to evaluate the risk of major adverse cardiovascular events (MACE) and major bleeding associated with ticagrelor versus clopidogrel in patients undergoing percutaneous coronary intervention (PCI) due to acute coronary syndrome by chronic liver disease status. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - April 17, 2024 Category: General Medicine Authors: Bin Hong, Sungho Bea, Seng Chan You, Yoosoo Chang, Won Kim, Ju-Young Shin Tags: Clinical Research Study Source Type: research
Health Systems Science Integration in Graduate Medical Education: A Pathway to Quintuple Aim Success for Independent Practice
The United States continues to outspend other high-income countries on health care without improving health outcomes.1 This understanding has been a launching pad for changes to health care structure and processes and movement towards achieving the Institution of Healthcare Improvement (IHI) Quintuple Aim.2 While health systems evolve in the approaches to health care delivery, education on these fundamental skills for the professional medical community has lagged. The American Medical Association (AMA) instituted health systems science (HSS) in 2013 as a third pillar of medical education, bringing national attention to the...
Source: The American Journal of Medicine - April 11, 2024 Category: General Medicine Authors: Sonia Bharel, Brian McGillen, Rachel Salas, Dharmini Shah Pandya Tags: AAIM Perspectives Source Type: research
A Physician's Rejoinder to Negative Secular Trends: Reframing Excellence in American Meritocracy and Educational Equity
Dr. Doroghazi's ironically titled “Negative Secular Trends in Medicine: Part X: The Dumbing Down of America,”1 renders a critique of a high school's realignment of honors classes “to boost equity.” Efforts to achieve equity in education, he claims, are “a threat to the basic fabric of our society.” These claims are not s upported by the evidence he cites, an article in the Wall Street Journal which he misinterprets and, in doing so, hastily conflates Tocqueville, the concept of meritocracy, and the concept of justice. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - April 8, 2024 Category: General Medicine Authors: Fernando L ópez Tags: Letter Source Type: research
Characteristics and outcomes of hospitalised patients with heart failure and sarcoidosis: a propenisty-matched analysis of the nationwide readmissions database 2010-2019
Sarcoidosis is associated with a poor prognosis. There is a lack of data examining the outcomes and readmission rates of sarcoidosis patients with heart failure (SwHF) and without heart failure (SwoHF). We aimed to compare the impact of non-ischemic heart failure on outcomes and readmissions in these two groups. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - April 6, 2024 Category: General Medicine Authors: Raheel Ahmed, Hiroyuki Sawatari, Khadija Amanullah, Joseph Okafor, Syed Emir Irfan Wafa, Saurabh Deshpande, Kamleshun Ramphul, Isma Ali, Mohammed Khanji, Sebastian Mactaggart, Omar AbouEzzeddine, Vasilis Kouranos, Rakesh Sharma, Virend K. Somers, Selma F. Tags: Clinical Research Study Source Type: research
Opportunities and Limitations of Renal Denervation: Where Do We Stand?
Hypertension is a primary contributor to cardiovascular disease, and the leading risk factor for loss of quality adjusted life years. Up to 50% of the cases of hypertension in the US remain uncontrolled. Additionally, 8-18% of the hypertensive population have resistant hypertension, uncontrolled pressure despite three different anti-hypertensive agents. Recently, catheter-based, percutaneous renal denervation emerged as a method for ablating renal sympathetic nerves for difficult to control hypertension. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - April 6, 2024 Category: General Medicine Authors: Beatriz Castillo Rodriguez, Eric A. Secemsky, Rajesh V. Swaminathan, Dmitriy N. Feldman, Markus Schlaich, Yuri Battaglia, Edward Filippone, Chayakrit Krittanawong Tags: Review Source Type: research
Medicine is Much More Complex than a Media Soundbite
Today (March 19th, 2024), the media airwaves and the internet, along with social media, were flooded with reports of a “study” that found that the dietary approach of intermittent fasting adversely affects cardiovascular health. In fact, the American Heart Association (AHA) webpage title proclaimed “8-hour time-restricted eating linked to a 91% higher risk of cardiovascular death.”1 When I heard of this stud y, as a practicing cardiologist who had followed outcomes pertaining to intermittent fasting and published on the effects of fasting,2 as well as taken part in intermittent fasting and time restricted eating my...
Source: The American Journal of Medicine - April 6, 2024 Category: General Medicine Authors: Amgad N. Makaryus Tags: Commentary Source Type: research
Practice for real life: Diversifying cases in educational conferences
Case-based clinical-reasoning conferences, such as internal medicine morning report, typically have a familiar cadence. The case presenter initially describes a patient's symptoms and illness history and subsequently provides a one-time physical exam and one-time laboratory and radiographic information. Facilitators help coordinate audience discussion, which often focuses on differential diagnosis, whether interwoven throughout the presentation or occurring entirely after the case presentation is completed. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - April 6, 2024 Category: General Medicine Authors: Erin H. Yang, Zaven Sargsyan, Stephanie V. Sherman, Prathit A. Kulkarni Tags: Commentary Source Type: research
Mild Cognitive Impairment and the Missed Opportunity to Prevent Dementia
Recent political events have called the public's attention to the diagnosis of mild cognitive impairment (MCI) in older people with concerns about cognitive function. Perhaps, it is time for the medical community to reflect on the potential of formally screening and offering interventions for mild cognitive impairment as a means to reduce the prevalence of dementia. Up to 40% with mild cognitive impairment may progress to dementia but could benefit from screening that is currently only done in 25% of annual Medicare exams. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - April 6, 2024 Category: General Medicine Authors: Arnold R. Eiser Tags: Commentary Source Type: research
Eosinophilic Pustular Folliculitis in an HIV-Positive 63-Year-Old Male
A 63-year-old male with a medical history including hypertension, hyperlipidemia, diabetes mellitus, asthma, and recently diagnosed human immunodeficiency virus (HIV, CD4 380 cells/mm3, viral load 681) was admitted with fever, cough, and altered mental status. The patient's initial clinical presentation and immunocompromised status prompted the consideration of various infectious and malignant etiologies. He was ultimately admitted and diagnosed with sepsis secondary to a superimposed bacterial pneumonia. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - April 6, 2024 Category: General Medicine Authors: Michelle Sikora, Michael G. Buontempo, Vignesh Ramachandran, Dorothy A. Knutsen, Shane A. Meehan, Emily Z. Hejazi, Avrom S. Caplan, Kristen Lo Sicco, Ian W. Tattersall Tags: Images in Dermatology Source Type: research
Multimodal Machine Learning for Prediction of 30-day Readmission Risk in Elderly Population
: Readmission within 30 days is a prevalent issue among elderly patients, linked to unfavorable health outcomes. Our objective was to develop and validate multimodal machine learning models for predicting 30-day readmission risk in elderly patients discharged from internal medicine departments. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - April 6, 2024 Category: General Medicine Authors: Ranel Loutati, Arie Ben-Yehuda, Shai Rosenberg, Yakir ttenberg Source Type: research
Imbalanced Brain Neurochemicals in long COVID and ME/CFS: A Preliminary Study using MRI
This study aims to measure brain neurochemical levels in long COVID and ME/CFS patients as well as healthy controls to investigate associations with severity measures. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - April 6, 2024 Category: General Medicine Authors: Kiran Thapaliya, Sonya Marshall-Gradisnik, Natalie Eaton-Fitch, Zeinab Eftekhari, Maira Inderyas, Leighton Barnden Source Type: research
Lipoprotein insulin resistance score and mortality risk stratification in heart failure
Higher total serum cholesterol is associated with lower mortality in heart failure. Evaluating associations between lipoprotein subfractions and mortality among people with heart failure may provide insights into this observation. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - April 5, 2024 Category: General Medicine Authors: Sarah Turecamo, Carolina G. Downie, Anna Wolska, Samia Mora, James D. Otvos, Margery A. Connelly, Alan T. Remaley, Katherine M. Conners, Jungnam Joo, Maureen Sampson, Suzette J. Bielinski, Joseph J. Shearer, V éronique L. Roger Tags: Clinical Research Study Source Type: research
Paraneoplastic Eczematous Dermatitis with Palmoplantar Keratoderma as an Initial Manifestation of Acute Myeloid Leukemia
A 74-year-old man with history of hypertension and chronic hepatitis C infection presented to the hospital with a two-week history of subjective fevers and unintentional weight loss of ten pounds. He also noted a one-year history of a worsening pruritic rash on his palms and soles that had been refractory to treatment. He denied a childhood history of atopy or allergies and had no prior history of eczematous dermatitis. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - April 5, 2024 Category: General Medicine Authors: Sarthak Singh Saxena, Danielle M. Tartar, Swati Shripad Patki, Lucy Shi Tags: Images in Dermatology Source Type: research
An Unusual Case of Brain Abscess in a HIV Negative Host
A 45-years-old previously healthy male presented with intermittent diffuse chronic headache of mild to moderate grade intensity for 8 months initially 1-2 times a month now daily episodes with increased severity since 1 month partially relieved with analgesics with blurring of vision in bilateral eyes. He also reported an intermittent fever of up to 102 F for two weeks around two months back. On examination, vitals were stable with neurological examination showing the presence of neck rigidity only, with normal cranial nerve and fundus examination. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - April 4, 2024 Category: General Medicine Authors: Harleen Sood, Nupur Pradhan, Harpreet Singh, Deba Prasad Dhibhar, Murali Krishna Bethanbhatla, Harsimran Kaur, Kirti Gupta, Vikas Suri, Ashish Bhalla Tags: Clinical Communication to the Editor Source Type: research
Exploring Cognitive Dysfunction in Long COVID Patients: Eye Movement Abnormalities and Frontal-Subcortical Circuits Implications via Eye-Tracking and Machine Learning
Cognitive dysfunction is regarded as one of the most severe aftereffects following coronavirus disease 2019 (COVID-19). Eye movements, controlled by various brain regions, including the dorsolateral prefrontal cortex and frontal-thalamic circuits, offer a potential metric for evaluating cognitive dysfunction. We aimed to examine the utility of eye movement measurements in identifying cognitive impairments in long COVID patients. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - April 4, 2024 Category: General Medicine Authors: Juli án Benito-León, José Lapeña, Lorena García-Vasco, Constanza Cuevas, Julie Viloria-Porto, Alberto Calvo-Córdoba, Estíbaliz Arrieta-Ortubay, María Ruiz-Ruigómez, Carmen Sánchez-Sánchez, Cecilia García-Cena Source Type: research
