Making the heart grow stronger: reversal of dilated cardiomyopathy in an elderly patient.
A 63 year old black woman presented with dyspnoea and dependant edema. She had noticed progression of her symptoms over 2 weeks prior to presentation and denied other symptoms. She had been diagnosed with heart failure with reduced ejection fraction 6 years previously on the basis of echocardiographic findings showing global left ventricular hypokinesis and an estimated ejection fraction of 22%. An encompassing diagnosis of ischemic cardiomyopathy was made at that time and she was commenced on treatment with a beta blocker, ACE inhibitor, aspirin, statin and a loop diuretic. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - April 22, 2022 Category: General Medicine Authors: Andrew Jamieson Tags: Clinical Communication to the Editor Source Type: research

Transfusion in Older Anemic Patients: Should the Troponin Value Be Taken Into Account?
Transfusion of red blood cells is part of the therapeutic arsenal for anemia, which is very frequent in the elderly. The prevalence of anemia can be as high as 60% in acute geriatric departments,1 and the condition has a heavy burden considering that it is associated with increased mortality and decreased functional and cognitive status.2 The current recommendations for chronic anemia include transfusion thresholds of 7 g/dL in the absence of cardiovascular disease, and 8 g/dL for patients with cardiovascular disease. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - April 22, 2022 Category: General Medicine Authors: Manon Thevenin, Sophie Putot, Patrick Manckoundia, Alain Putot Tags: Clinical Research Study Source Type: research

Outcomes and Resource Utilization in Patients Hospitalized with Gastrointestinal Bleeding Complicated by Types 1 and 2 Myocardial Infarction
We examined clinical profiles and the prognostic impact of both MI types on outcomes of patients hospitalized with GIB. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - April 22, 2022 Category: General Medicine Authors: Salik Nazir, Abdul Mannan Khan Minhas, Matt Deshotels, Ishan S. Kamat, Tayyab Cheema, Yochai Birnbaum, George V. Moukarbel, Biykem Bozkurt, Roy Hemant, Hani Jneid Tags: Clinical Research Study Source Type: research

Acute Myocardial Infarction Following Hospitalization for Gastrointestinal Bleeding: Incidence, Predictors, Management, and Outcomes
Clinical characteristics of patients with acute myocardial infarction after gastrointestinal bleeding are poorly characterized.  We sought to evaluate the incidence, management and outcomes of myocardial infarction following hospitalization for gastrointestinal bleeding. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - April 22, 2022 Category: General Medicine Authors: Gregory D. Rubinfeld, Jeffrey S. Berger, Nathaniel R. Smilowitz Tags: Clinical Research Study Source Type: research

Sickle Cell Trait and Risk for Common Diseases: Evidence from the UK Biobank
Sickle cell trait is typically considered benign. Although evidence remains inconsistent, recent studies suggest that it is associated with several common diseases. We systematically assessed associations of sickle cell trait with reported diseases in a large population-based cohort. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - April 21, 2022 Category: General Medicine Authors: Joseph Hulsizer, W. Kyle Resurreccion, Zhuqing Shi, Jun Wei, Skylar Ladson-Gary, S. Lilly Zheng, Brian T. Helfand, Liana Billings, Michael S. Caplan, Jianfeng Xu Tags: Clinical Research Study Source Type: research

There Must Be Something in the Water: An Unusual Cutaneous Infection
A 77-year-old man presented to the emergency department with a 6-week history of a nonhealing violaceous nodular plaque on the dorsum of his right hand after he sustained a minor puncture injury on the side of a boat while sailing on the Chesapeake Bay. His past medical history was significant for heart failure with preserved ejection fraction, chronic kidney disease stage 3, coronary artery disease, aortic stenosis, and gout. Given lack of healing over the subsequent weeks, he twice sought care at local urgent care centers without response to cephalexin and later clindamycin. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - April 21, 2022 Category: General Medicine Authors: S. Gaine, M.T. Melia, M. Marchitto, S. Rozati, Alexandra J. Horne Tags: Diagnostic Dilemma Source Type: research

Changes in Lung Perfusion in Patients Treated with Percutaneous Mechanical Thrombectomy for Intermediate-Risk Pulmonary Embolism
: Current pulmonary embolism treatment options rely heavily on anatomical clot location. However, anatomical location does not necessarily determine adverse outcomes; rather, clinical severity is secondary to the degree of perfusion impairment. Dual-energy computed tomography pulmonary angiogram (DE-CTPA) can map perfusion at the time of pulmonary embolism diagnosis. Single-photon emission computed tomography ventilation-perfusion (SPECT-V/Q) scans allow for perfusion tracking similar to DE-CTPA. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - April 21, 2022 Category: General Medicine Authors: Shameek Gayen, Vruksha Upadhyay, Maruti Kumaran, Riyaz Bashir, Vladimir Lakhter, Joseph Panaro, Gerard Criner, Simin Dadparvar, Parth Rali Source Type: research

There Must Be Something in the Water – an Unusual Cutaneous Infection
A 77-year-old man presented to the emergency department with a six-week history of a non-healing violaceous nodular plaque on the dorsum of his right hand after he sustained a minor puncture injury on the side of a boat while sailing on the Chesapeake Bay. His past medical history was significant for heart failure with preserved ejection fraction, chronic kidney disease stage 3, coronary artery disease, aortic stenosis, and gout. Given lack of healing over the subsequent weeks, he twice sought care at local urgent care centers without response to cephalexin and later clindamycin. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - April 21, 2022 Category: General Medicine Authors: Gaine S, Melia MT, Marchitto M, Rozati S, Horne AJ Tags: Diagnostic Dilemma Source Type: research

Sickle Cell Trait and Risks for Common Diseases: Evidence from the UK Biobank
Sickle cell disease is an autosomal recessive disease caused by the inheritance of two pathogenic mutations of the hemoglobin subunit beta gene (HBB) (usually Glu6Val, though other pathogenic mutations exist).1 The altered hemoglobin makes red blood cells prone to being crescent-shaped, which can cause vaso-occlusion and result in numerous serious complications and comorbidities including: vaso-occlusive crisis, acute chest syndrome, infections, pulmonary hypertension, stroke, pulmonary embolism, renal failure, retinopathy, splenic sequestration, priapism, cholelithiasis, and osteonecrosis. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - April 21, 2022 Category: General Medicine Authors: Joseph Hulsizer, W. Kyle Resurreccion, Zhuqing Shi, Jun Wei, Skylar Ladson-Gary, S. Lilly Zheng, Brian T. Helfand, Liana Billings, Michael S. Caplan, Jianfeng Xu Source Type: research

Late rejection of an abdominal wall mesh
A 51-year-old patient presented with an abdominal mass of the right hypochondrium. She has a medical history of a right subcostal laparotomy for cholecystectomy 6 years ago. She had also a prosthetic repair of a subcostal incisional hernia one year after the first surgery. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - April 21, 2022 Category: General Medicine Authors: Houssem Harbi, Kais Fourati, Nozha Toumi Source Type: research

Erratum to ‘Minimizing Diagnostic Error: The Importance of Follow-Up and Feedback’, The American Journal of Medicine (2008) Vol 121 (5A), S38-S42
The publisher regrets that two of the Tables in the published version of this study were incorrectly titled. Table 2 should be titled “Expanded paradigms in diagnosis”, not “Limitations of using successful or failed “treatment response” as an indicator for diagnostic error”; Table 3 should read “Limitations of using successful or failed “treatment response” as an indicator for diagnostic error”, not “Factors complicating assessment of treatment response”. The Tables with their correct titles are shown below. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - April 19, 2022 Category: General Medicine Authors: Gordon D. Schiff Tags: ERRATUM Source Type: research

Long COVID and Medicine's Two Cultures
Medicine has separated the two cultures of biological science and social science in research, even though they are intimately connected in the lives of our patients. To understand the cause, progression and treatment of Long COVID, biology and biography, the patient's lived experience, must be studied together. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - April 9, 2022 Category: General Medicine Authors: Ralph I. Horwitz, Allison Hayes Conroy, Mark R. Cullen, Katharine Colella, McKayla Mawn, Burton H. Singer, Ida Sim Tags: Review Source Type: research

Pseudohyperkalemia: Three Cases and a Review of Literature
Hyperkalemia is a potentially fatal complication requiring prompt diagnosis and management. However, pseudohyperkalemia, defined as an artificial rise in serum potassium (Sk) is also an important diagnosis since management differs. Pseudohyperkalemia can result from multiple factors including excessive potassium leakage from cells of the forearm during blood collection due to release from exercising muscle during fist clenching while washout is prevented by tourniquet application, hemolysis, problems with sample transport, pre-analysis or contamination, cell damage and metabolic changes, familial conditions that permit exc...
Source: The American Journal of Medicine - April 7, 2022 Category: General Medicine Authors: Kimia Saleh-Anaraki, Anjuli Jain, Christopher S. Wilcox, Negiin Pourafshar Tags: Review Source Type: research

Triaging Admissions: A Survey of Internal Medicine Resident Experiences and Perceptions and Recommendations on Inpatient Triage Education
Transitions of care (TOCs) have been identified as critically important for patient safety. The Joint Commission Center for Transforming Healthcare, World Health Organization, and national societies have emphasized the importance of TOCs.1,2 The literature on TOCs has focused on inpatient to outpatient transitions, and handovers within the hospital.3 Inpatient to outpatient TOCs emphasize communication at discharge and medicine reconciliation to prevent adverse events and readmissions.4 In contrast, the process of admitting patients from outpatient to inpatient settings has only recently begun to receive attention. (Source...
Source: The American Journal of Medicine - April 4, 2022 Category: General Medicine Authors: Emily S. Wang, Sadie Trammell Vel ásquez, Michael Mader, Joel C. Boggan, Jeff E. Liao, Luci K. Leykum, Jacqueline Pugh, Triagist Collaborative Group Source Type: research

Oral Anticoagulant Use for Patients with Atrial Fibrillation with Concomitant Anemia and/or Thrombocytopenia
Atrial fibrillation is the most common sustained cardiac arrhythmia in clinical practice, which is associated with an increased risk of thromboembolism, heart failure and mortality.1 Previous studies in atrial fibrillation patients have reported that abnormal hemoglobin and platelet counts may be associated with adverse events. However, these studies that specifically examined the associations between hemoglobin and platelet levels and adverse outcomes reported conflicting data.2-5 Although warfarin effectively reduces the risk of ischemic stroke by 64% compared to placebo/control,6 and non-vitamin K antagonist oral antico...
Source: The American Journal of Medicine - April 2, 2022 Category: General Medicine Authors: Yung-Hsin Yeh, Yi-Hsin Chan, Shao-Wei Chen, Shang-Hung Chang, Chun-Li Wang, Chi-Tai Kuo, Gregory Y.H. Li, Shih-Ann Chen, Tze-Fan Chao Tags: Clinical Research Study Source Type: research