COVID-19 and Light Chain Amyloidosis: Correspondence
We would like to discuss the article “COVID-19 and Light Chain Amyloidosis (AL), Adding Insult to Injury,”1 published in a recent issue of The American Journal of Medicine. Crees and Stockerl-Goldstein mentioned that “… overlap creates unique challenges in caring for patients with AL which are further compounded by the immunosu ppressive nature of anti-plasma cell therapies, the need for frequent clinical assessments and the exclusion of AL patients from initial COVID-19 vaccine trials…”1 We agree that managing COVID-19 and administering COVID-19 immunization to patients with underlying disease can be difficult...
Source: The American Journal of Medicine - May 27, 2022 Category: General Medicine Authors: Rujittika Mungmunpuntipantip, Viroj Wiwanitkit Tags: Letter Source Type: research

The Reply
We thank Dr Reiffel for his letter regarding our recently published article in The American Journal of Medicine.1 We agree with many of his comments when considering how to apply the study results to clinical practice. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - May 27, 2022 Category: General Medicine Authors: George Cholack, Geoffrey D. Barnes Tags: Letter Source Type: research

The Importance of Shared Decision-Making
Thank you for publishing the outstanding and important article, “Sense and Sensibility”1 in the December 2021 issue of The American Journal of Medicine. The story Dr. Schattner related in "Sense and Sensibility" resonates with me in that, in my role in undergraduate and graduate medical education, learners (students and residents) should ALWAYS be reminded t hat, in her words, “Once the patient's individual circumstances are acknowledged, shared decision-making may achieve optimal comprehensive health outcomes, and this is particularly true in old patients.” I have found this to be true in virtually all patients, a...
Source: The American Journal of Medicine - May 27, 2022 Category: General Medicine Authors: Daniel M. Lichtstein Tags: Letter Source Type: research

Comments on COVID-19 and AL Amyloidosis, the Missing Links
Crees and Stockerl-Goldstein1 recently reviewed the management of light chain (AL) amyloidosis during the coronavirus disease 2019 (COVID-19) pandemic. While the literature discussed by authors is pertinent, certain lacunae in the diagnosis, prevention, and management need attention. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - May 27, 2022 Category: General Medicine Authors: Ankur Jain Tags: Letter Source Type: research

The Reply
Although I am grateful for Prof. Daniel Lichtstein's comments on my article,1 I can hardly refrain from pointing out the wide gap that often exists between the practice of medicine as reflected by many editorials and writings of educators and ad hoc committees2 and what is going on in the “real world.” Nowhere is this gap more striking than in regard to shared decision-making. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - May 27, 2022 Category: General Medicine Authors: Ami Schattner Tags: Letter Source Type: research

Table of Contents
(Source: The American Journal of Medicine)
Source: The American Journal of Medicine - May 27, 2022 Category: General Medicine Source Type: research

Plus ça change, plus c'est la même chose* [The More Things Change, the More They Remain the Same.]
During my 5 years of medical school, I spent 1 summer and 1 year performing clinical research in the Clinical Physiology Laboratory (Klinisk Fysiologisk Laboratorium) at Bispebjerg Hospital in Copenhagen, Denmark. The head of the laboratory at that time, Niels A. Lassen, MD, was a world's authority on measuring blood flow in a variety of organs using radioactive tracers. He had learned the technique while studying at the National Institutes of Health under Dr Seymour S. Kety. The technique for measuring blood flow was simple and elegant. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - May 27, 2022 Category: General Medicine Authors: Joseph S. Alpert Tags: Commentary Source Type: research

Artificial intelligence-based stethoscope for the diagnosis of aortic stenosis
The diagnostic accuracy of the stethoscope is limited and highly dependent on clinical expertise. Our purpose was to develop an electronic stethoscope, based on artificial intelligence (AI) and infrasound, for the diagnosis of aortic stenosis (AS). (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - May 27, 2022 Category: General Medicine Authors: Tamer Ghanayim, Lior Lupu, Sivan Naveh, Noa Bachner-Hinenzon, Doron Adler, Salim Adawi, Shmuel Banai, Avinoam Shiran Source Type: research

Controversies in hypertension I: the Optimal Assessment of Blood Pressure Load and Implications for Treatment
The most important factor in treating hypertension is assessing an individual patient's true blood pressure load, the cornerstone being research-grade office determination. Office blood pressure should be supplemented with out-of-office measurement, including home and ambulatory monitoring (if available), which we consider complimentary and not interchangeable. Controversy remains for initiation of treatment of white-coat hypertension, where cardiovascular risk lies between normotension and sustained hypertension; antihypertensive therapy should be considered unless low cardiovascular risk, wherein pressures should be foll...
Source: The American Journal of Medicine - May 27, 2022 Category: General Medicine Authors: Edward J Filippone, Andrew J Foy, Gerald V Naccarelli Tags: Review Source Type: research

The Nursing Home Crisis: Prognosis Guarded
On February 28, 2022, the White House released a detailed “Fact Sheet” replete with plans to “improve the safety and quality of nursing home care, hold nursing homes accountable for the care they provide, and make the quality of care and facility ownership more transparent.”1 The proposed reforms were further highlighted during the State of the Uni on Address wherein President Biden noted that “Medicare is going to set higher standards for nursing homes and make sure your loved ones get the care they deserve and expect.”2 The hoped for reforms are intent on ensuring that “every nursing home provides a suffici...
Source: The American Journal of Medicine - May 27, 2022 Category: General Medicine Authors: Eli Y. Adashi, I. Glenn Cohen Tags: Commentary Source Type: research

A Curious Case of Diarrhea, Pancreatitis, and Rash
A previously healthy 54-year-old man presented with watery diarrhea, abdominal pain, nausea, and weight loss. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - May 27, 2022 Category: General Medicine Authors: Brooke Jennings, Andrew Bryant Tags: Diagnostic Dilemma Source Type: research

Management of antiplatelet therapy in patients with coronary stents undergoing noncardiac surgery
In clinical practice, significant variability exists with regards to the timing of elective noncardiac surgery after percutaneous coronary intervention (PCI) and the perioperative management of antiplatelet therapy.1 Although coronary revascularization should not be performed with the intent to reduce perioperative risks of noncardiac surgery, 2 up to 20% of the patients who have undergone PCI undergo noncardiac surgery within 2 years; 3.5% to 7.5% of these surgeries occur within 6 months of PCI. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - May 27, 2022 Category: General Medicine Authors: Nidhi Rohatgi, James L. Zehnder, Nathaniel R. Smilowitz Tags: Commentary Source Type: research

Alarming Trends: Mortality from Alcoholic Cirrhosis in the United States
Alcoholic cirrhosis is an advanced form of alcohol-related liver disease. In the United States (US) between 2010 and 2016, alcohol-related liver disease was the primary cause of nearly 1 in 3 liver transplants, surpassing hepatitis C. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - May 27, 2022 Category: General Medicine Authors: Orly Termeie, Lawrence Fiedler, Lisa Martinez, Jennifer Foster, Parvathi Perumareddi, Robert S. Levine, Charles H. Hennekens Tags: Brief Observation Source Type: research

Estimation of Right Atrial Pressure Using a Portable Handheld Ultrasound
Handheld ultrasound devices are increasingly used by clinicians for their ease of use and portability. Their utility for estimating right atrial pressure (RAP) is poorly described. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - May 27, 2022 Category: General Medicine Authors: Mohammed Elzeneini, Shishir Gupta, Yujia Li, Yi Guo, Robert Hamburger Tags: Brief observation Source Type: research

Controversies in Hypertension II: the Optimal Target Blood Pressure
The optimal target blood pressure in the treatment of hypertension is undefined. Whether more intense therapy is better than standard, typically (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - May 27, 2022 Category: General Medicine Authors: Edward J Filippone, Andrew J Foy, Gerald V Naccarelli Tags: Review Source Type: research