Peeking Inside The Box
A checklist and template mindset is being increasingly employed by physicians. It brings structure to what can be a chaotic environment, prevents us from forgetting to ask important questions, and allows for appropriate reproducibility across different operators1. However, while efficient, this approach is not sufficient. When used to gather medical histories and other core information, it can reduce communicating with patients to a pro forma activity that feeds the electronic beast while obscuring opportunities to learn and engage. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - January 30, 2022 Category: General Medicine Authors: Charles Goldberg Source Type: research

Updates for Health Providers on Monoclonal Antibodies for COVID-19: Promising Adjunct but not Alternative to Vaccinations
The United States (US) rapidly became and remains to this date the epicenter of the pandemic of COVID-19 based on total cases and deaths. As of December 14, 2021, the US has experiences over 50 million cases and 800,000 deaths. Healthcare providers should be aware that 119 days elapsed between reaching the 600,000 and 700,000 death milestones but only 74 days elapsed between 700,000 and 800,000. In the US, 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. (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 Source Type: research

Modernizing medical culture: Time to embrace healthcare workers with disabilities
The eyes of others our prisons; their thoughts our cages. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - January 30, 2022 Category: General Medicine Authors: Ryan M. McAdams, Mary Sesto, Pamela J. Kling Tags: Embrace healthcare workers with disabilities Source Type: research

TEMPORARY REMOVAL: Neuromuscular Complications of Systemic 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 - January 29, 2022 Category: General Medicine Authors: Dina Namiranian, Stefanie Geisler Tags: Review Source Type: research

Finding Meaning: Internal Medicine Clerkship Director Burnout and Professional Fulfillment
Burnout is prevalent among medical students, residents, and practicing physicians1 –7 and is recognized as having adverse consequences including patient outcomes, such as reduced patient satisfaction8,9 and adverse patient safety events.10 There are also personal consequences related to professionalism lapses9; burnout is associated with interpersonal conflicts within and outsid e of the workplace7. Physicians with leadership roles in medical education are not immune to burnout.5,6,11 (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - January 29, 2022 Category: General Medicine Authors: Temple A. Ratcliffe, Harish Jasti, Jordan Ortiz, Camilla Curren, Chavon Onumah, Jonathan Ripp, Amber T. Pincavage Tags: AAIM Perspective Source Type: research

Neuromuscular complications of systemic amyloidosis
Systemic amyloidosis is characterized by extracellular deposition of insoluble fibrillar proteins in multiple tissues, frequently at a distance from the site of synthesis. The two most common forms, light chain (AL) and transthyretin (ATTR) amyloidosis can cause peripheral neuropathy and, rarely, myopathy. Diagnosis can be challenging, and abundant suspicion is required to identify patients. As neurological manifestations of amyloidosis may precede involvement of other organs by several years, recognizing amyloid neuropathy and myopathy are crucial, especially in this new and exciting era of effective therapies for AL and ...
Source: The American Journal of Medicine - January 29, 2022 Category: General Medicine Authors: Dina Namiranian, Stefanie Geisler Source Type: research

Choose wisely: Clinical diagnostic reasoning over technological expediency
…To make perfect the most difficult of all arts, the art of observation, to call to aid the science of experimentation, to cultivate the reasoning of faculty, so as to be able to know the true from false-these are our methods. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - January 28, 2022 Category: General Medicine Authors: L. Maria Belalcazar, Roshaneh Ali Tags: Commentary Source Type: research

REMOVED: Renal Amyloidosis: Presentation, Diagnosis, and Management
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.The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - January 23, 2022 Category: General Medicine Authors: Reena Gurung, Tingting Li Tags: Review Source Type: research

TEMPORARY REMOVAL: Introduction to “Proceedings from Amyloidosis, A Hidden Disease with a Bright Future: A Multi-Disciplinary Approach to Diagnosis and Management of 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.The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - January 23, 2022 Category: General Medicine Authors: Kathleen W. Zhang, Daniel J. Lenihan Source Type: research

In Search of Coronary Thrombosis as the Cause of Myocardial Infarction: Unraveling a 20th-Century Mystery
For the greater part of the 20th century, the pathophysiology of acute myocardial infarction regarding whether thrombosis was either present or primary was debated until 1973 when pathologists and clinicians met and by consensus, finally decided that the data supported that transmural infarction (what we now refer to as ST elevation myocardial infarction or STEMI) was caused by thrombus in the vessel supplying the infarcted territory. As the data for this consensus came from pathological analysis, it took another 7 years until angiographic and interventional data in humans with acute presentations of transmural infarction ...
Source: The American Journal of Medicine - January 23, 2022 Category: General Medicine Authors: John A. Ambrose, Damon J. McEnroe Tags: Review Source Type: research

Renal Amyloidosis: Presentation, Diagnosis, and Management
More than 35 amyloid precursor proteins have been identified and many have tropism for the kidney. Renal amyloidosis is most commonly seen in AL and AA amyloidosis and the main clinical manifestations are proteinuria and progressive renal dysfunction. On renal pathology, hallmark findings of amyloidosis include Congo red positivity with apple-green birefringence and randomly arranged fibrils measuring 7-12 nm in diameter on ultrastructural examination. Management of renal amyloidosis typically combines therapy targeting the underlying amyloid process and supportive management. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - January 23, 2022 Category: General Medicine Authors: Reena Gurung, Tingting Li Source Type: research

Introduction to “Proceedings from Amyloidosis, A Hidden Disease with a Bright Future: A Multi-Disciplinary Approach to Diagnosis and Management of Amyloidosis”
Amyloidosis is a heterogeneous disease that can be challenging to diagnose, frequently eluding even the most astute clinicians. Whether the clinical presentation is primarily cardiac, neurological, gastrointestinal, or renal in nature, symptoms are generally nonspecific and frequently attributed to more common causes of disease without consideration of amyloidosis. The multi-system nature of amyloidosis further complicates diagnosis. While characteristic patterns of multi-organ dysfunction can be a “red flag” finding that points to the correct diagnosis, all too often specialists fail to pick up on abnormal signs or sy...
Source: The American Journal of Medicine - January 23, 2022 Category: General Medicine Authors: Kathleen W. Zhang, Daniel J. Lenihan Source Type: research

Prevention and Management of Hypertriglyceridemia-Induced Acute Pancreatitis during Pregnancy: A Systematic Review
Severe gestational hypertriglyceridemia can lead to acute pancreatitis, with maternal mortality rate ∼ 20%. The recent National Lipid Association part 2 expert panel recommendations provide guidance on monitoring pregnant women at high risk for hyperlipidemia. We suggest that high risk women have triglyceride levels checked once every trimester. Fasting triglycerides> 250 mg/dL should prompt monthly triglyceride levels, screening for gestational diabetes and implementing a strict low carbohydrate, low fat diet, exercise. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - January 23, 2022 Category: General Medicine Authors: Manasvi Gupta, Besiana Liti, Christopher Barrett, Paul D. Thompson, Antonio B. Fernandez Source Type: research

In search of coronary thrombosis as the cause of myocardial infarction: unraveling a 20th century mystery
Today, all medical students are taught that the standard of care in the management of acute ST-elevation myocardial infarction is early lysis of clot in the affected coronary artery with mechanical (percutaneous intervention) or if unavailable, drug therapy with thrombolytic agents. The sooner the intervention is performed to open the infarct-related artery, the greater the salvage of myocardium. After percutaneous intervention with stenting, most patients can be discharged within 2 days after the procedure on appropriate medical therapy. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - January 23, 2022 Category: General Medicine Authors: John A. Ambrose, Damon J. McEnroe Tags: Review Source Type: research

TEMPORARY REMOVAL: Developing Therapy for Transthyretin 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 - January 22, 2022 Category: General Medicine Authors: Courtney M. Campbell, Kathleen Zhang, Daniel J. Lenihan, Ronald Witteles Tags: Review Source Type: research