Chest Pain and Inflammation: A Story Where Hickam's Dictum Prevailed
While Occam's razor refers to a single condition explaining a patient's clinical presentation, Hickam's dictum serves as the counterbalance to this phrase such that symptoms can be secondary to a variety of diagnoses. Here, we present a case of a patient whose presentation was due to the latter. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - May 16, 2022 Category: General Medicine Authors: Kris Kumar, Joshua C. Vogt, Ahmad Masri, Harsh Golwala, Firas E. Zahr, Punag H. Divanji, Hind Rahmouni, Babak Nazer Source Type: research

Domestic physical activity and new-onset hypertension: A nationwide cohort study in China
Previous studies had suggested that leisure physical activity was inversely associated with the risk of hypertension.1-2 Accordingly, leisure physical activity has been recommended as a preventive lifestyle behavior for hypertension in some of the hypertension guidelines.3-5 However, in most of the developing countries, only a small segment of the population (lower than 10%) reported participating in any form of leisure physical activity.6 Instead, domestic physical activity is one of the major sources of energy expenditure in these countries, especially among females and older adults. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - May 14, 2022 Category: General Medicine Authors: Rui Li, Qinqin Li, Shaojie Zhang, Yuanyuan Zhang, Panpan He, Zhuxian Zhang, Mengyi Liu, Chun Zhou, Ziliang Ye, Qimeng Wu, Sisi Yang, Yanjun Zhang, Huan Li, Chengzhang Liu, Xianhui Qin Tags: Clinical Research Study Source Type: research

Collateral Damage
After more than 2 years of waxing and waning, the COVID pandemic is quieting down. We are all holding our breaths and hoping that another variant does not appear and lead to another surge of hospitalizations. The pandemic has caused global chaos, pain, misery, death, and economic deprivation. Hospitals were stressed to their limits, and face to face events disappeared. During hospitalization peaks, quarantine measures resulted in periods of “no visitors.” Locking out visitors and family increased levels of misery for patients and their significant others. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - May 14, 2022 Category: General Medicine Authors: Joseph S. Alpert Tags: Commentary Source Type: research

Association of angiotensin receptor blockers with incident Parkinson's disease in patients with hypertension: A retrospective cohort study
Parkinson's disease (Parkinson's disease) is the second most common neurodegenerative disease after Alzheimer's disease,1 and is mainly characterized by progressive motor symptoms, including resting tremors, bradykinesia, rigidity, and postural dysreflexes. Its main pathological hallmark is a selective loss of dopaminergic neurons in the substantia nigra pars compacta, resulting in dopamine depletion in the striatum. Despite a variety of symptom-alleviating medications for Parkinson's disease, disease modification treatments are not yet available. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - May 14, 2022 Category: General Medicine Authors: Hsiu-Chen Lin, Yuan-Fu Tseng, Ai-Ling Shen, Jane Chen-Jui Chao, Chien-Yeh Hsu, Hsiu-Li Lin Source Type: research

Correlation of Pyuria and Bacteriuria in Acute Care
Pyuria is a relatively common finding in many hospitalized patients 1,2,3, and its presence is heavily relied on for the diagnosis of urinary tract infection 4. However, not all patients with pyuria/bacteriuria should be treated with antibiotics, especially those without localizing signs and symptoms based on current guidelines 5; even though such guidance is based mainly on expert opinions and lacks a well-designed random controlled trial (RCT) to provide evidence support 5. The investigation of links between urinary tract infection and non-specific symptoms such as delirium is inconclusive 6. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - May 14, 2022 Category: General Medicine Authors: Bo Cheng, Mufrad Zaman, William Cox Tags: Clinical research study Source Type: research

Face Off: 3D Printed Masks as a Cost-Effective and Reusable Alternative to N95 Respirators: A Feasibility Study
The N95 filtering facepiece respirator (N95 respirator or N95 mask) was first patented in 1995 by Taiwanese-American Peter Tsai1. This mechanical filter respirator, approved by National Institute for Occupational Safety and Health (NIOSH), was designed to filter 95% of particulates (but not gases or vapors). Its efficacy is dependent on appropriate user usage and mask size and fit to ensure adequate seal, thus requiring regulated, yearly medical evaluations and fit testing.2. While originally designed for industry use, the N95 respirator is more effective than surgical masks in protecting the wearer from environmental path...
Source: The American Journal of Medicine - May 14, 2022 Category: General Medicine Authors: Marc Levine, Lance Levine, Helen Xun, Prakash J. Mathew, Devinder Singh, Adam Gerber, Michael Antonietti Tags: Clinical Research Study Source Type: research

Long-term cardiac monitoring after embolic stroke of undetermined source. Search longer – look harder
Ischemic stroke is a heterogeneous syndrome which may result from several causes such as atherosclerosis, small vessel disease and atrial fibrillation.1 Despite an extensive diagnostic work-up during the acute or chronic phase of the ischemic stroke, the cause of ischemic stroke remains unexplained for 20% of patients, termed cryptogenic stroke. 2 3 (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - May 14, 2022 Category: General Medicine Authors: Dimitrios Sagris, Stephanie L Harrison, Benjamin J.R Buckley, George Ntaios, Gregory Y.H Lip Source Type: research

Alcohol Consumption and Cardiovascular Health
The 2015 to 2025 Dietary Guidelines for Americans define moderate drinking as having up to one drink per day for women and up to two drinks per day for men.1 Alcohol consumption above the recommended limits was associated with higher all-cause and cause-specific mortality risk [39- 126%].2 Alcohol may contain polyphenols, amino acids, minerals,3 though the content varies considerably among types of alcohol (beer vs red wine vs white wine vs spirit). A complete understanding of these complex mechanisms in human health is limited. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - May 14, 2022 Category: General Medicine Authors: Chayakrit Krittanawong, Ameesh Isath, Robert S Rosenson, Muzamil Khawaja, Zhen Wang, Sonya E. Fogg, Salim S. Virani, Lu Qi, Yin Cao, Michelle T. Long, Christy C Tangney, Carl J Lavie Tags: Clinical Research Study Source Type: research

Intolerable unilateral hip pain: Clues from the history
There is no financial support or other benefits from commercial sources for the work reported on in the manuscript, or any other financial interests that any of the authors may have, which could create a potential conflict of interest or the appearance of a conflict of interest with regard to the work. Each of the authors has participated in the preparation of the manuscript. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - May 14, 2022 Category: General Medicine Authors: Jenice X. Cheah, Naziheh Assarzadegan, Jyotsna Ghosh, Caoilfhionn M. Connolly, Allan C. Gelber Tags: Clinical Communication to the Editor Source Type: research

An Insight for Sore Eyes
A month into my second year of residency, I was diagnosed with an eye disease that required me to go on medical leave for months. As a physician, having a disease that precluded me from reading about my own health condition was both infuriating and eye-opening (though perhaps not in the way I had wanted at the time). (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - May 13, 2022 Category: General Medicine Authors: Lochan M. Shah Tags: Personomics Source Type: research

Wilson's disease – never too late
A 43-year-old man presented with a four-month history of abdominal bloating, loss of appetite and 5 kg weight loss. He was previously fit and well, with no history of alcohol or drug ingestion, and no prior blood transfusion. Clinical examination revealed pigmentation around the cornea of both eyes, consistent with Kayser-Fleischer (KF) rings (Fig. 1A), but there were no other clinical features of chronic liver disease. On abdominal examination there was no organomegaly. He had no neurological deficits. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - May 13, 2022 Category: General Medicine Authors: Anand K Annamalai, Venkatesh N Prajna, Gunja Chowdhury, Radhakrishnan Santhi, Mariappan Kannan, Srinivasan Vedantham, Mark Gurnell Tags: Clinical Communication to the Editor Source Type: research

Primary Medical Care Integrated with Healthy Eating and Healthy Moving is Essential to Reduce Chronic Kidney Disease Progression
Chronic kidney disease is among the few chronic diseases in the US with increasing prevalence 1, is the ninth leading cause of US mortality 2 and is increasing disability-adjusted life years lost 1, 3. Patients with chronic kidney disease contribute broadly to US mortality because they have increased risks for heart disease 4, cancer for those over age 65 years 5, and stroke 6 which represent, respectively, the first, second, and fifth causes of US mortality 2. Because patients with chronic kidney disease more likely die from these diseases before progressing to end-stage kidney disease 7, their deaths from these non-chron...
Source: The American Journal of Medicine - May 13, 2022 Category: General Medicine Authors: Donald E. Wesson, Vandana Mathur, Navdeep Tangri, Sarah Hamlett, David A. Bushinsky, L. Ebony Boulware Tags: Narrative Review Source Type: research

The Effect of Creative Arts Therapy on Psychological Distress in Healthcare Professionals
Healthcare professionals experience significant work-related psychological distress that has been exacerbated by the COVID-19 pandemic.1-4 This work-related psychological distress increases in settings that do not recognize the importance of creating healthy work environments, develop structures for peer support, or prioritize self-care and wellness. Even in supportive work settings, healthcare professionals may not share their own trauma and emotional experiences, and feel the need to process these events on their own. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - May 13, 2022 Category: General Medicine Authors: Marc Moss, Anthony Edelblute, Hillary Sinn, Kristen Torres, Jeri Forster, Tisha Adams, Courtney Morgan, Michael Henry, Katherine Reed Tags: Clinical Research Study Source Type: research

Malignant Pleural Effusion: Presentation, Diagnosis, and Management
Malignant pleural effusions are common in patients with cancer. Most malignant pleural effusions are secondary to metastases to the pleura, most often from lung or breast cancer. The presence of malignant effusion indicates advanced disease and poor survival; in lung cancer, the presence of malignant effusion upstages the cancer to stage 4. Usually presenting as a large, unilateral exudative effusion, most patients with malignant pleural effusion experience dyspnea. Prior to intervention, diagnosis of malignant pleural effusion and exclusion of infection should be made. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - May 13, 2022 Category: General Medicine Authors: Shameek Gayen Tags: Review Source Type: research

Murine Typhus Induced Myocarditis
We describe a case of murine typhus presenting as myocarditis in the setting of suspected acute coronary syndrome. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - May 13, 2022 Category: General Medicine Authors: Riya Madan, Varsha Muthukumar, Sarah Premji, Rujman Khan, R. Michelle Schmidt Tags: Clinical Communication to the Editor Source Type: research