The effect of hospital visitor policies on patients, their visitors, and healthcare providers during the COVID-19 pandemic: a systematic review
Healthcare policymaking during the SARS-CoV-2 (COVID-19) pandemic has questioned the precedent of restricting hospital visitors. We aimed to synthesize available data describing the resulting impact on patient, family/visitor, and healthcare provider wellbeing. We systematically reviewed articles from the World Health Organization COVID-19 Global Literature on Coronavirus Disease Database published between December 2019 through April 2021. Included studies focused on hospitalized patients and reported one or more pre-specified main or secondary outcome (COVID-19 disease transmission, global wellbeing, mortality, morbidity,...
Source: The American Journal of Medicine - April 23, 2022 Category: General Medicine Authors: Audra N. Iness, Jefferson O. Abaricia, Wendemi Sawadogo, Caleb M. Iness, Max Duesberg, John Cyrus, Vinay Prasad Tags: Review Source Type: research

Cocaine and the long-term risk of cardiovascular disease in women
Cardiovascular disease is a leading cause of death in women,1 yet little attention is paid to illicit substances that can adversely affect the cardiovascular system.2 –4 Mortality due to substance use is increasing in women, including deaths from stimulants such as cocaine.5 Cocaine is derived from Erythroxylon coca (coca bush) and is one of the most frequently used illicit substances in North America. Reports suggest that about 1% of adolescent girls and young women use cocaine.6–8 Cocaine is extremely addictive and may lead to cocaine use disorders that have a significant impact on women. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - April 23, 2022 Category: General Medicine Authors: U. Vivian Ukah, Brian J. Potter, Gilles Paradis, Nancy Low, Aimina Ayoub, Nathalie Auger Tags: Clinical Research Study Source Type: research

Stamping Out the Medicaid Coverage Gap: An ACA Imperative
In one of its most striking features, the Patient Protection and Affordable Care Act (ACA) expanded Medicaid eligibility for nearly all U.S. citizens and legal resident adults between the ages of 19-64 whose total household income stood at ≤138% of the Federal Poverty Level.1 To effectuate this goal, states were to receive enhanced federal matching funds commensurate with their Federal Medical Assistance Percentages (FMAPs).1 In so doing, the ACA set in motion a viable pathway for millions of low-income working-age adults who are in eligible to partake in the ACA marketplace to attain health coverage. (Source: The Americ...
Source: The American Journal of Medicine - April 23, 2022 Category: General Medicine Authors: Eli Y. Adashi, Daniel P. O'Mahony, I. Glenn Cohen Tags: Commentary Source Type: research

Frank's sign in a double stroke patient
A 72-year-old male, non-smoker, with a medical history of hypertension, hypercholesterolemia, atrial fibrillation and a past myocardial infarction 15 years ago, presented to the emergency department complaining about difficulty of speaking and left-hand weakness of 6-hour duration. Apart from an elevated blood pressure, at 170/100 mmHg, physical examination revealed dysarthria, accompanied by left brachial monoplegia and hypoesthesia. A bilateral earlobe wrinkle extending obliquely and backward, at a 45o angle, from the tragus to the edge of the auricle (Frank's sign) was observed (Figure 1A). (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - April 23, 2022 Category: General Medicine Authors: Konstantinos C. Christodoulou, Ioannis Stouras, Xafnoula Zlatidou, Despoina Kakagia Tags: Clinical Communication to the Editor Source Type: research

Influence of neighborhood conditions on recurrent hospital readmissions in patients with heart failure: A cohort study
Hospital readmissions are common and costly among heart failure patients. More than 50% of patients are readmitted within six months after discharge.1 Some readmissions may be driven by care processes that are under the control of hospitals or providers while others are more likely to result from patient- and community-level factors.1 (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - April 23, 2022 Category: General Medicine Authors: Mario Schootman, Brian C. Steinmeyer, Ling Chen, Robert M. Carney, Michael W. Rich, Kenneth E. Freedland Source Type: research

Reversed Halo Sign on Chest Computed Tomography in a 33-Year-Old Man Without Immunosuppression
A 33-year-old man presented to the emergency department (ED) with fatigue, lack of appetite, abdominal pain, and arthralgia for 14 days. He had already consulted his general practitioner 10 days previously, who suspected a diverticulitis and initiated antibiotic treatment with ciprofloxacin and metronidazole. Because his symptoms did not improve, a computed tomography (CT) scan of the abdomen was performed, which was unremarkable. However, as pulmonary infiltrates were evident in the basal lungs, the patient was referred to the ED for further evaluation. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - April 22, 2022 Category: General Medicine Authors: Sarah Dr äger, Kathleen Jahn, Moritz Vogt, Helmut Hopfer, Diego Kyburz, Michael Osthoff Tags: Diagnostic Dilemma Source Type: research

Making the Heart Grow Stronger: Reversal of Dilated Cardiomyopathy in an Elderly Patient
A 63-year-old black woman presented with dyspnea and dependent edema. She had noticed progression of her symptoms over the prior 2 weeks to presentation and denied other symptoms. She had been diagnosed with heart failure with reduced ejection fraction 6 years previously based on 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

Look Past Stubborn
The information received from the overnight team is straightforward: another woman who doesn't take her insulin and has a high A1C. She was tossed into the pile many overtired providers build up in their mind, the heap of patients who are not compliant with their prescribed medications, and therefore: why should we care for patients who will not care for themselves? I go to see her on morning rounds. Aside from the A1C, I also know that the patient didn't come in on her own. She was dropped off by a friend worried about her ability to care for herself at home. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - April 22, 2022 Category: General Medicine Authors: Michelle Izmaylov Tags: Personomics Source Type: research

The CMS Vaccine Mandate at the Supreme Court: A Hippocratic Imperative
On January 13, 2022, in a 5-4 decision in Biden v. Missouri, the Supreme Court of the United States stayed two lower court decisions enjoining the Centers for Medicare& Medicaid Services (CMS) vaccine mandate. The mandate, now in effect, requires all facilities that participate in Medicare and Medicaid to ensure that their staff is vaccinated against COVID –19 absent medical and religious exemptions.1 The injunction that the Supreme Court dissolved would have blocked the enforcement of the mandate in a total of 24 states. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - April 22, 2022 Category: General Medicine Authors: Eli Y. Adashi, I. Glenn Cohen Tags: Commentary Source Type: research

A woman who couldn't hear
To the Editor, (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - April 22, 2022 Category: General Medicine Authors: Ankur Jain, Sumita Chaudhry, Monica Sharma Tags: Clinical Communication to the Editor Source Type: research

Superior Vena Cava Thrombosis
A 60-year old man presented to our unit for iterative episodes of lipothymia and prominent superficial collateral venous circulation of the trunk (Figure 1a) after he was lost to follow-up for 4 years. He received two successive bone marrow transplantations in 2012 for dendritic cell leukemia. Heterozygous prothrombin G20210A mutation was found after a superior vena cava thrombosis from the implantable port occurred in 2015 with a recurrence in 2016 after anticoagulation was stopped. In 2017, a 12-cm long stent was implanted in the superior vena cava, and tinzaparin was given. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - April 22, 2022 Category: General Medicine Authors: Etienne RIVIERE, Claire BAZIN Source Type: research

Idiopathic Basal Ganglia Calcifications and Parkinson's Disease
A 57-year-old man presented to the Neurology Clinic with a 6-year history of progressive bilateral static tremor, bradykinesia, and gait initiation difficulty. His non-motor manifestations included constipation and pollakiuria. Initial levodopa test revealed excellent responsiveness, with the Unified Parkinson's Disease Rating Scale (UPDRS) scores improving from 57 to 14 points (75%). No signs of atrophy in the cerebrum, cerebellum, and brain stem were found on the magnetic resonance imaging. Parkinson's disease was clinically diagnosed. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - April 22, 2022 Category: General Medicine Authors: Xiaopeng Guo, Honglin Hao, Hao Xing, Yi Guo Tags: Clinical communication to the editor Source Type: research

It is time to abandon the use of body surface area derived from a 100-year-old formula
Clinical parameters and drug dosing indexed to body surface area (BSA) have been widely used. For example, cardiologists use indexation to BSA for the cardiac linear measurements, aortic valve area (AVA), stroke volume, left ventricular mass, et al.; Oncologists use BSA indexed dosing for chemotherapeutic agents; Nephrologists use indexation of renal function parameters to BSA. BSA is calculated by the two most commonly used formulas, Du Bois& Du Bois ’(Du Bois) or Mosteller's formula. However, despite its wide utilization, little attention was paid to the accuracy and validation of the calculated BSA. (Source: The Ameri...
Source: The American Journal of Medicine - April 22, 2022 Category: General Medicine Authors: Haoyi Zheng Tags: Commentary Source Type: research

Risk factors for climate-related health effects in an ambulatory population
: Climate change is a global health crisis. In most regions, heat waves are expected to become longer and more frequent and air quality is expected to worsen. Few physicians discuss climate and health with patients and related guidelines are lacking. Our objective was to quantify the prevalence of risk factors for illness related to climate change in the U.S. ambulatory setting. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - April 22, 2022 Category: General Medicine Authors: Joanne Bernstein, Caitlin Rublee, Cynthia Kay, Jeffrey L. Jackson Source Type: research

Microvascular dysfunction as a systemic disease: A review of the evidence
Microvascular dysfunction describes a varied set of conditions which includes vessel destruction, abnormal vasoreactivity, in situ thrombosis, and fibrosis which ultimately results in tissue damage and progressive organ failure. Microvascular dysfunction has a wide array of clinical presentations, ranging from ischemic heart disease to renal failure, stroke, blindness, pulmonary arterial hypertension, and dementia. An intriguing unifying hypothesis suggests that microvascular dysfunction of specific organs is an expression of a systemic illness that worsens with age and is accelerated by vascular risk factors. (Source: The...
Source: The American Journal of Medicine - April 22, 2022 Category: General Medicine Authors: Daniel S. Feuer, Eileen M. Handberg, Borna Mehrad, Janet Wei, C. Noel Bairey Merz, Carl J. Pepine, Ellen C. Keeley Tags: Review article Source Type: research