New Drugs Approved in 2021
In 2021, the US Food and Drug Administration (FDA) approved 50 novel drugs.1 Several expedited review pathways, including accelerated approval, priority review, fast track, and breakthrough therapy, allow for approval processes that allow drugs to be available earlier than had they undergone review in the traditional pathway. Ultimately, this allows for expedited approval and availability of drugs that treat a serious condition or fill an unmet medical need. Of the novel drug approvals in 2021, 37 of the 50 (74%) drugs were processed via one of the expedited review pathways, and 26 of the 50 (52%) were approved for treatme...
Source: The American Journal of Medicine - February 27, 2022 Category: General Medicine Authors: Alex M Ebied, Hesham Elmariah, Rhonda M Cooper-DeHoff Tags: Review Source Type: research

TEMPORARY REMOVAL: Management of Cardiac Symptoms in Amyloidosis
The publisher regrets that this article has been temporarily removed. A replacement will appear as soon as possible in which the reason for the removal of the article will be specified, or the article will be reinstated. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - February 26, 2022 Category: General Medicine Authors: Phillip King, Andrew M. Kates Source Type: research

Management of Cardiac Symptoms in Amyloidosis
Cardiac amyloidosis (CA) results in symptoms of heart failure, atrial and ventricular arrythmias, conduction disturbances, and profound autonomic dysfunction. These symptoms present unique management challenges as compared to patients without CA and can be very debilitating. Thus, management of the cardiovascular symptoms of these patients plays a central role in their care. This review presents an overview of the typical cardiovascular manifestations encountered in patients with CA and highlights the key management considerations for each. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - February 26, 2022 Category: General Medicine Authors: Phillip King, Andrew M. Kates Tags: Review Source Type: research

Leveraging Electronic Health Records to Measure Low-Value Screening Colonoscopy
Among over 6 million screening colonoscopies performed annually in the United States (U.S.), up to one-third may represent potential overuse.1,2 Colorectal cancer (CRC) screening overuse is defined as screening in specific clinical scenarios that provide no net benefit to individuals, such as screening too frequently or outside the age of eligibility.3,4,5 Colonoscopy overuse is an important problem because it can cause direct patient harm (e.g., 0.3% complication rate leading to hospitalization or death), raise healthcare costs, and reduce availability of appropriate endoscopy for other individuals. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - February 24, 2022 Category: General Medicine Authors: Camille Soroudi, John Mafi, Anthony Myint, Juliana Gardner, Sartajdeep Kahlon, Margaret Mongare, Liu Yang, Chi-Hong Tseng, Courtney Reynolds, Vishnu Nair, Chad Villaflores, Reinalyn Cates, Reshma Gupta, Catherine Sarkisian, Folasade P. May Tags: Advancing High-Value Care Source Type: research

Electronic Population Health Tools Enhance Preventive Care for Older Adults
By 2030, those ages 45 and older will constitute 43% of Americans vastly outnumbering those 18 and younger1. Older individuals are at particularly high risk for solid malignancy and vaccine preventable illness. As such, the United States Preventive Services Task Force (USPSTF) and Centers for Disease Control and Prevention (CDC) have published guidelines to maximize their well-being. Unfortunately, uptake of these recommendations is suboptimal and health disparities exist. For example, California currently has a lung cancer screening rate of 1% of eligible adults (national average is 5%), which ranks 49th of 50 states2. (S...
Source: The American Journal of Medicine - February 24, 2022 Category: General Medicine Authors: Eric W. Chak, Elizabeth Cortez-Toledo, Randy Luna, Scott MacDonald, Susan L. Stewart, David T Cooke, Moon S. Chen Tags: Digital Health Enhances Preventive Medicine Source Type: research

Paraneoplastic dermatomyositis
A Hispanic man in his 50s —recently diagnosed with acral lentiginous melanoma—presented for evaluation of a tender, photodistributed rash which was first appreciated approximately 10 weeks prior. Review of systems was notable for difficulty lifting objects above his head. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - February 24, 2022 Category: General Medicine Authors: Cody Orton, Christina Topham, Lauren M. Madigan Tags: Images in Dermatology Source Type: research

Holding hands till eternity
The first time I saw Bob, he had just been transferred from the ICU to a step-down unit. At first glance, he painted a sorry picture. An emaciated man with multiple bruises all over the body. He was sitting in his bed with a hunched back. He reminded of this tree in fall denuded of all its leaves and with a trunk whose bark is spotted with lichens. But once I started talking to him, I could quickly see the fire within him. He had barely survived a blood infection due to a bad pneumonia. But the willpower in him seemed indefatigable. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - February 24, 2022 Category: General Medicine Authors: Bibek Koirala Tags: Personomics Source Type: research

Ramsay Hunt Syndrome
A 48-year-old male patient presented with left-sided earache and deviation of mouth to the right side for 3 days. He had no similar previous history. Examination revealed an inflamed pinna with vesicles on its surface [Fig 1] and lower motor neuron VII Nerve palsy [Fig 2]. A diagnosis of Ramsay Hunt syndrome was made and the patient was started on oral Prednisolone 50mg tapered over 10 days along with acyclovir 800mg five times a day. The lesions gradually resolved completely and the patient is asymptomatic at 2 months follow up. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - February 24, 2022 Category: General Medicine Authors: Dr Satvinder Singh Bakshi, Dr Seepana Ramesh, Dr Chandra Shekhar Annam Tags: Clinical Communication to the Editor Source Type: research

Immunomediated Sequential Dissection of Visceral Arteries: Dramatic Improvement After Steroid Therapy
We present the case of a man with spontaneous, progressive, multivessel dissection of the abdominal arteries occurring a few days after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination. After a few days of conventional treatment, initiation of steroids and immunoglobulins produced a dramatic improvement of the clinical course, suggesting an immune-mediated causative mechanism. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - February 22, 2022 Category: General Medicine Authors: Alessandra Pina, Andrea Farina, Stefano Savonitto Tags: Clinical Communication to the Editor Source Type: research

Immuno-mediated Sequential Dissection of Visceral Arteries: dramatic improvement after steroid therapy
We present the case of a young man with spontaneous, progressive, multivessel dissection of the abdominal arteries occurring a few days after SARS-CoV-2 vaccination. After a few days of conventional treatment, initiation of steroids and immunoglobulins produced a dramatic improvement of the clinical course, suggesting an immune-mediated causative mechanism. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - February 22, 2022 Category: General Medicine Authors: Alessandra Pina, Andrea Farina, Stefano Savonitto Tags: Clinical communication to the Editor Source Type: research

Braden Skin Score Subdomains Predict Mortality Among Cardiac Intensive Care Patients
We examined the association between each of the 6 individual BSS subscores with hospital mortality in patients in the CICU. We hypothesized that BSS subscores reflecting patient frailty would have a stronger association with outcomes. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - February 21, 2022 Category: General Medicine Authors: Benjamin S. Brueske, Mandeep S. Sidhu, Isabella Y. Chang, Brandon M. Wiley, Joseph G. Murphy, Courtney E. Bennett, Gregory W. Barsness, Jacob C. Jentzer Tags: Clinical Research Study Source Type: research

Superior Vena Cava Syndrome as Sequelae of Novel Hodgkin Lymphoma
The prevalence of superior vena cava syndrome has been estimated to be around 15,000 people in the United States each year, with an incidence of 1 in 650 to 1 in 3100 patients.1 It was first described by William Hunter in 1757 as a complication of a saccular aortic aneurysm.2 Superior vena cava obstruction often impairs blood flow through the superior vena cava, resulting in a collection of signs and symptoms that together constitute superior vena cava syndrome. Around 50 years ago, infectious causes, especially syphilitic aortic aneurysm and tuberculosis, accounted for the majority of cases of superior vena cava syndrome....
Source: The American Journal of Medicine - February 21, 2022 Category: General Medicine Authors: Mohammed Alkhero, Megha Shalavadi, Daniel Stenberg, Robin Abdelmalik Tags: Clinical Communication to the Editor Source Type: research

Rapidly progressive hair loss may be the only sign of syphilis
A previously healthy 20-year-old woman was referred to our dermatology clinic with a 1-month history of progressive cranial hair loss. She had been treated with topical steroids but with little effect. Clinical examination found diffuse non-scarring hair loss in the frontal, parietal, and temporal regions, with no erythematous background (Figure A). In addition, a trichoscopic examination revealed a small number of yellow dots and villus hairs. Exclamation mark hairs were not observed. There were no other skin, mucosal, or nail symptoms. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - February 21, 2022 Category: General Medicine Authors: Sho Katayama, Mitsuhito Ota Tags: Clinical Communication to the Editor Source Type: research

Braden skin score sub-domains predict mortality among cardiac intensive care patients
We examined the association between each of the 6 individual BSS sub-scores with hospital mortality in CICU patients. We hypothesized that BSS sub-scores reflecting patient frailty would have a stronger association with outcomes. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - February 21, 2022 Category: General Medicine Authors: Benjamin S. Brueske, Mandeep S. Sidhu, Isabella Y. Chang, Brandon M. Wiley, Joseph G. Murphy, Courtney E. Bennett, Gregory W. Barsness, Jacob C. Jentzer Tags: Clinical Research Study Source Type: research

Superior Vena Cava Syndrome as sequelae of novel Hodgkin's Lymphoma
To the Editor (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - February 21, 2022 Category: General Medicine Authors: Mohammed Alkhero, Megha Shalavadi, Daniel Stenberg, Robin Abdelmalik Source Type: research