Association of Optimism With Cardiovascular Events and All-Cause Mortality: Systematic Review and Meta-Analysis
In early 2021, a Scientific Statement From the American Heart Association asserted that psychological health is an essential component of wellness/well-being for patients with and at risk for cardiovascular disease, and that there is high quality data showing clear associations between psychological health and cardiovascular disease risk.1 In addition, there is increasing evidence suggesting that interventions to improve psychological health can have a beneficial impact on cardiovascular health as well. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - February 3, 2022 Category: General Medicine Authors: Chayakrit Krittanawong, Neil Sagar Maitra, Hafeez Ul Hassan Virk, Sonya Fogg, Zhen Wang, Scott Kaplin, David Gritsch, Eric A Storch, Philippe N Tobler, Dennis S. Charney, Glenn N Levine Tags: Clinical Research Study Source Type: research

Comments on the Coffee Bean Sign and Visual Inspection
We read with interest the article by Mizumoto about the coffee bean sign finding on inspection that developed as a result of sigmoid volvulus in an 87-year-old male patient.1 It was previously reported that the visibility of peristalsis on inspection was 31.9% in endemic and 7.3% in sporadic areas.2 As mentioned by Mizumoto, careful physical examination is important in general surgery practice and can be especially effective in diagnosing elderly patients with debility and neurological disease. Turkey is an endemic region for sigmoid volvulus. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - February 1, 2022 Category: General Medicine Authors: Ufuk Uylas, Ramazan Gundogdu Tags: Letter Source Type: research

Peripheral Arterial Disease, Stroke, and Mortality in Patients with Atrial Fibrillation
I read the paper by Vitalis et al1 with great interest. The authors assessed the impact of peripheral arterial disease on mortality and stroke in patients with atrial fibrillation. The adjusted hazard ratio (HR) (95% confidence interval [CI]) of peripheral arterial disease in patients with atrial fibrillation for all-cause mortality was 1.34 (1.06-1.70). In addition, the adjusted HR (95% CI) of peripheral arterial disease in patients with nonanticoagulated atrial fibrillation for ischemic stroke was 3.37 (1.25-9.09). (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - February 1, 2022 Category: General Medicine Authors: Tomoyuki Kawada Tags: Letter Source Type: research

New Lyme Disease Guidelines for Erythema Migrans Lesions Miss the Mark
If the primary treatment goal for managing patients with erythema migrans (EM) rashes is to restore patients to their pre-Lyme health status, then the guidelines endorsed by Auwaerter et al1 are both inadequately sourced and potentially dangerous.2 Of the 2 trials cited by the authors in support of a 10-day doxycycline regimen, only 1 is applicable to US patients. In that study, almost half of the subjects in each arm failed to complete the 30-month trial.3 At the 12-month observation point, 72% (44 out of 61) had a complete response to therapy, suggesting that this regimen is not highly effective and puts many at risk for...
Source: The American Journal of Medicine - February 1, 2022 Category: General Medicine Authors: Elizabeth L. Maloney Tags: Letter Source Type: research

The Reply
We are grateful to Kawada for the interest in our paper.1 Peripheral arterial disease is an independent risk factor for the development of atrial fibrillation.2-4 The coexistence of peripheral arterial disease and atrial fibrillation have significant additive effects on the increased risk of mortality, cardiac, and cerebrovascular complications.2 (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - February 1, 2022 Category: General Medicine Authors: Antonios Vitalis, Alena Shantsila, Gregory Y.H. Lip Tags: Letter Source Type: research

The Reply
I would like to thank Uylas and Gundogdu for their important and thoughtful comment on our case report.1 Patients with sigmoid volvulus should receive immediate treatment, and quick suspicion of this disease on visual examination and palpation may lead to good patient outcomes. Their comment highlighted that high-touch medicine may contribute to high-quality care rather than high-tech medicine, which relies too much on computed tomography or other imaging tests.2,3 I agree that von Wahl sign is a valuable physical finding and physicians should enhance their skills of physical examination. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - February 1, 2022 Category: General Medicine Authors: Junki Mizumoto Tags: Letter Source Type: research

The Reply
We appreciate Dr. Maloney responding to our Lyme disease guideline review.1 (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - February 1, 2022 Category: General Medicine Authors: Paul G. Auwaerter, Takaaki Kobayashi, Gary P. Wormser Tags: Letter Source Type: research

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

An Enigmatic Case of Hashimoto's Thyroiditis
A 60-year old male state worker was seen at our facility for the first time in 2017 for thyroid evaluation with a diagnosis of Hashimoto's thyroiditis and hypothyroidism who had been treated with varying doses of 50-200 ugm of levothyroxine for several years. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - February 1, 2022 Category: General Medicine Authors: Joseph R. Tucci Source Type: research

Updates for Health Providers on Monoclonal Antibodies for COVID-19: Less Promising Adjunct and Never an Alternative to Vaccinations
The United States rapidly became and remains to this date the epicenter of the COVID-19 pandemic, based on total cases and deaths. As of December 14, 2021, the United States has experienced over 50 million cases and 800,000 deaths. Healthcare providers should be aware that 119 days elapsed between the 600,000 and 700,000 death milestones but only 74 days elapsed between 700,000 and 800,000. In the United States, deaths have increased by 27.8% and averaged 1283 per day during the past week. In contrast, the capacity of a 747-400 jet is 416 people. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - January 30, 2022 Category: General Medicine Authors: Maja Berges, Keith Foster, Jennifer Foster, Lisa Martinez, Sean Martinez, Benjamin Fiedler, David L. DeMets, Dennis G. Maki, Charles H. Hennekens Tags: Commentary Source Type: research

Health Care Fraud: The Leading Violation of the False Claims Act
It is a sign of the times when the lion share of the schemes intent on defrauding the federal government are in the health care arena.1 Data reported by the Department of Justice (DOJ) reveal that 80% of the $11.4 billion recovered over the last four years under the False Claims Act (31 U.S.C. §§ 3729 – 3733) involved “health care fraud matters.”1 What has been dubbed “An American Sickness” of the “Medical-Industrial Complex” appears to be alive and well long after the ‘80s during which the corporatization of healthcare was glamorized. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - January 30, 2022 Category: General Medicine Authors: Eli Y. Adashi, I. Glenn Cohen JD Source Type: research

External Validation of a Laboratory Prediction Algorithm for the Reduction of Unnecessary Labs in the Critical Care Setting
Unnecessary laboratory tests are a major source of waste in the United States healthcare system1. Prior studies suggest that 20% of labs performed are unnecessary2, wasting $200 billion dollars each year3. In addition to cost, unnecessary labs also impact health. Excessive blood loss from unnecessary labs can lead to hospital-acquired anemia and exposes patients to the sequelae of anemia, which include the risks of blood tansfusions, increased morbidity and mortality4-6. The risk of severe iatrogenic anemia is greater in children due to their smaller size and blood volume. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - January 30, 2022 Category: General Medicine Authors: Linda T. Li, Tongtong Huang, Elmer V. Bernstam, Xiaoqian Jiang Tags: Clinical Research Study Source Type: research

Unfinished Business: Bringing Greater Equity to Career Advancement and Promotions for Clinician Educators in Academic Medicine
Historical Background: Much of what we do in academic medicine today is rooted in history. Some aspects of our current practice have evolved, while others have not. An important example is the definition of scholarship for the purposes of advancement of clinician-educators. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - January 30, 2022 Category: General Medicine Authors: Sherine Salib, Mrinalini Kulkarni-Date, Read G. Pierce Tags: Commentary Source Type: research

A Letter to Internal Medicine Residents Serving on the Front Lines of the Pandemic: We see, hear, and feel you
There are many professions that deserve recognition for the selfless work of frontline COVID-19 clinical care: nurses, respiratory therapists, technicians, laboratorians, physical and occupational therapists, fellows, among others. Each of you deserves an emphatic word of thanks. But this letter is written to honor the internal medicine residents who have been providing clinical care on the wards, in the clinics, in the ER, and in the ICU – not just to people with COVID-19, but to our patients. As a versatile specialty that includes outpatient primary care as well as hospital service, internal medicine has been particula...
Source: The American Journal of Medicine - January 30, 2022 Category: General Medicine Authors: Lindsay Sonstein, Matthew Dacso Tags: Article Type: Commentary Source Type: research

Reversible Tumorous Pituitary Enlargement due to Primary Hypothyroidism
Funding: None (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - January 30, 2022 Category: General Medicine Authors: Dr Vikram Singh Shekhawat, Dr Ashima Chander Tags: Images in Radiology Source Type: research