Response to Commentary Promoting the New Lyme Disease Guidelines
Repeating incorrect information does not cause it to become correct. The erroneous statement by Auwaerter et al,1 that taking single-dose doxycycline after an Ixodes tick bite prevents Lyme disease, has not been demonstrated by any North American study to date. Although repeatedly cited as demonstrating this, the 2001 Nadelman study2 did not follow its subjects long enough to demonstrate this point. It is well known that later manifestations of Lyme disease may develop beyond the 6-week follow-up period used by the investigators. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - March 1, 2022 Category: General Medicine Authors: Beatrice M. Szantyr Tags: Letter Source Type: research

Risk vs Benefits of Thiazides in Clinical Use: Need for a Holistic Approach
Ravioli et al,1 through their cross-sectional observational analysis, conclude that thiazide use is a risk factor for hyponatremia, hypokalemia, syncope, and fall. However, a cause-and-effect relationship cannot be established merely based on observational data. Moreover, data from patients admitted to the emergency department are not representative of the general hypertensive population. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - March 1, 2022 Category: General Medicine Authors: Anil Pareek, Nitin Chandurkar, Shruti Dharmadhikari Tags: Letter Source Type: research

The Reply
Dr Szantyr, responding to our Lyme disease guideline review, questions the appropriateness of administering a single 200-mg dose of doxycycline within 72 hours of tick removal for prevention of Lyme disease following a high-risk tick bite.1 The Infectious Disease Society of America/American Academy of Neurology/American College of Rheumatology (IDSA/AAN/ACR) 2020 Lyme disease guideline used GRADE methodology to weigh the strength of evidence that guides recommendations.2 (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - March 1, 2022 Category: General Medicine Authors: Paul G. Auwaerter, Takaaki Kobayashi, Gary P. Wormser Tags: Letter Source Type: research

The Reply
In reply to the letter from Pareek et al on our study1 on the association between thiazide diuretic use and the prevalence of electrolyte disorders, syncope, and falls we would like to state the following: Our analysis of a large, real-life collective of patients clearly showed that thiazide diuretics were a strong risk factor for the presence of hyponatremia as well as hypokalemia. Of course, the study is a cross-sectional analysis and its results imply an association and not causality. On the other hand, the evidence is overwhelming: Not only does the mechanism of action of thiazide diuretics explain the potential for hy...
Source: The American Journal of Medicine - March 1, 2022 Category: General Medicine Authors: Gregor Lindner, Svenja Ravioli Tags: Letter Source Type: research

Table of Contents
(Source: The American Journal of Medicine)
Source: The American Journal of Medicine - March 1, 2022 Category: General Medicine Source Type: research

Corrigendum to “Health Care Workers Need COVID-19 Vaccination: Clinical, Public Health and Ethical Considerations” The American Journal of Medicine Vol. 134:12 p1437–1439
The authors regret that an error was made in the third paragraph of the article. That paragraph should read as follows: (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - March 1, 2022 Category: General Medicine Authors: Dennis G. Maki, Charles H. Hennekens Tags: Corrigendum Source Type: research

Association between Current and Cumulative Cannabis use and Heart Rate. The Coronary Artery Risk Development in Young Adults (CARDIA) Study.
: Resting heart rate can predict cardiovascular disease. Heart rate increases with tobacco smoking but its association with cannabis use is unclear. We studied the association between current and cumulative cannabis use and heart rate. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - March 1, 2022 Category: General Medicine Authors: Julian Jakob, Odile Stalder, Tali Kali, Etienne Pruvot, Mark J. Pletcher, Jamal S. Rana, Stephen Sidney, Reto Auer Tags: clinical research study, cohort study Source Type: research

Biologically Active Adrenomedullin (bio-ADM) is of potential value in identifying congestion and selecting patients for neurohormonal blockade in acute dyspnea
Dyspnea accounts for 5% of total emergency department visits, two-thirds of which require hospitalisation1. The in-hospital mortality rate of dyspneic patients remains relatively high and reaches 5-6%1,2. Moreover, a half of acute dyspnea patients are readmitted within 6 months, and readmission is closely related to a dramatically increased risk of death, irrespective of the initial cause of dyspnea3. Conventional signs and symptoms accompanying dyspnea are of limited value in differential diagnostics and risk stratification4. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - March 1, 2022 Category: General Medicine Authors: Justas Simonavi čius, Aurimas Mikalauskas, Kamilė Čerlinskaitė, Etienne Gayat, Vytautas Juknevičius, Eglė Palevičiūtė, Irina Alitoit-Marrote, Denis Kablučko, Loreta Bagdonaitė, Mindaugas Balčiūnas, Dovilė Vaičiulienė, Ieva Jonauskienė, Ju Tags: Clinical Research Study Source Type: research

Embedding Racial Justice and Advancing Health Equity at the American Medical Association
We write in response to a recent article in this journal calling for the American Medical Association (AMA), the Association of American Medical Colleges (AAMC), the National Medical Association (NMA) and organized medicine in general to support an antiracist reimagining of medical education and health care to address “unhealed wounds and unmet needs”.1 We agree with the authors’ historical review of institutional racism in organized medicine and the role of the AMA in that history. We also appreciate the AAMC's response offered in in this journal by Drs. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - March 1, 2022 Category: General Medicine Authors: Aletha Maybank, Fernando De Maio, Diana Lemos, Diana N. Derige Tags: Commentary Source Type: research

Fever, Myalgias, and Weakness in a Patient with HIV
A 62-year-old Bolivian man residing in Spain since 2002, diagnosed with human immunodeficiency virus (HIV) infection in 2014 and with poor adherence to antiretroviral therapy (bictegravir/emtricitabine/tenofovir alafenamide), presented to the Emergency Department with 2-month history of asthenia, myalgias, and weakness. He complained of increased weakness and pain in his right arm, in addition to edema and distal paresthesia 10 days after he received the pneumococcal conjugate vaccine (Prevenar 13) in the same arm. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - February 27, 2022 Category: General Medicine Authors: Marta Lobo Antu ña, Edwin Uriel Suárez M, Silvia Calpena Martínez, Fernando Lage Estebañez, Jose Fortes Alén, Miguel de Górgolas Hernández-Mora Tags: Diagnostic Dilemma Source Type: research

Fever, myalgias and weakness in a patient with HIV
A 62-year-old Bolivian man residing in Spain since 2002 diagnosed with HIV infection in 2014 and with poor adherence to antiretroviral therapy (bictegravir/emtricitabine/tenofovir alafenamide) presented to the emergency department with 2-month history of asthenia, myalgias, and weakness. He complained of increased weakness and pain in his right arm in addition to edema and distal paresthesia 10 days after he received the pneumococcal conjugate vaccine (PCV13/Prevnar) in the same arm. His most recent CD4+ T cell count was 174 cells/ml and he had a viral load of 114 copies/ml. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - February 27, 2022 Category: General Medicine Authors: Marta Lobo Antu ña, Edwin Uriel Suárez Merchán, Silvia Calpena Martínez, Fernando Lage Estebañez, Jose Fortes Alén, Miguel de Górgolas Hernández-Mora Tags: Diagnostic Dilemma Source Type: research

Amassing the Evidence
A previously healthy 22-year-old woman developed a painless mass on her right anteromedial thigh, with gradual enlargement over the preceding two months. There was no antecedent trauma. She otherwise felt well, without fevers, fatigue, night sweats or arthralgia. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - February 27, 2022 Category: General Medicine Authors: Eric J. Dein, Zsuzsanna H. McMahan, Allan C. Gelber, Uzma J. Haque Tags: Diagnostic Dilemma Source Type: research

Non-exercise estimated cardiorespiratory fitness and incident hypertension
Primary hypertension prevention remains a global public health challenge; 116 million (47%) Americans live with hypertension which make it a primary or contributing cause for nearly half a million deaths in the United States annually1, and worldwide the prevalence of hypertension is projected to increase around 60% by 20252. Existing data from large perspective studies such as the Aerobics Center Longitudinal Study (ACLS), Coronary Artery Risk Development in Young Adults (CARDIA) study, and others demonstrate that cardiorespiratory fitness, an objective indicator of recent habitual physical activity, is inversely associate...
Source: The American Journal of Medicine - February 27, 2022 Category: General Medicine Authors: Palakben Hasmukhbhai Patel, Mitchell Gates, Peter Kokkinos, Carl J. Lavie, Jiajia Zhang, Xuemei Sui Source Type: research

Cardiovascular benefits of digoxin and empagliflozin in patients with chronic heart failure: the DIG trial revisited
Cardiovascular benefits of empagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, in heart failure treatment continue to accumulate. Two large-scale trials have evaluated the effect of empagliflozin, a sodium –glucose co-transporter 2 (SGLT2) inhibitor, in patients with heart failure and a reduced ejection fraction (HFrEF) and patients with heart failure with a preserved ejection fraction (HFpEF).1, 2 Based on the EMPEROR-reduced trial, FDA recently approved empagliflozin to treat patients with HFrEF. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - February 27, 2022 Category: General Medicine Authors: Haoyi Zheng Tags: Commentary Source Type: research

A License To Practice Medicine Cannot Be A License To Harm
Why are physicians who advocate against Covid vaccines allowed to practice medicine? In the United States, one has the right to say anything one wants, no matter how stupid, hurtful or even potentially dangerous, but speech is not without consequences. Irresponsible, patently false speech by physicians, given their societal influence, can cause significant harm. Physicians who promote dangerous nonsense about medicine should not be allowed to work as doctors and care for patients, no matter how much access they have to social media, print or television. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - February 27, 2022 Category: General Medicine Authors: Neil W. Schluger, Kenneth Prager Source Type: research