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American Journal of Medicine

James E Dalen, Joseph S Alpert
A new suspected cause of cryptic strokes is "silent atrial fibrillation". Pacemakers and other implanted devices allow continuous recording of cardiac rhythm for months or years. They have discovered that short periods of atrial fibrillation lasting minutes or hours are frequent and usually are asymptomatic. A meta-analysis of 50 studies involving more than 10,000 patients with a recent stroke found that 7.7% had atrial fibrillation on their admitting EKG. In 3 weeks during and after hospitalization, another 16...
October 15, 2016: American Journal of Medicine
Carolyn M Clancy, David Atkins
No abstract text is available yet for this article.
October 14, 2016: American Journal of Medicine
Samuel A Silver, Ziv Harel, Eric McArthur, Danielle M Nash, Rey Acedillo, Abhijat Kitchlu, Amit X Garg, Glenn M Chertow, Chaim M Bell, Ron Wald
BACKGROUND: The risk of hospital readmission in acute kidney injury (AKI) survivors is not well understood. We estimated the proportion of AKI patients who were rehospitalized within 30 days and identified characteristics associated with hospital readmission. METHODS: We conducted a population-based study of patients who survived a hospitalization complicated by AKI from 2003-2013 in Ontario, Canada. The primary outcome was 30-day hospital readmission. We used a propensity score model to match patients with and without AKI, and a Cox proportional hazards model with death as a competing risk to identify predictors of 30-day readmission...
October 14, 2016: American Journal of Medicine
Kristi Reynolds, Alan S Go, Thomas K Leong, Denise M Boudreau, Andrea E Cassidy-Bushrow, Stephen P Fortmann, Robert J Goldberg, Jerry H Gurwitz, David J Magid, Karen L Margolis, Catherine J McNeal, Katherine M Newton, Rachel Novotny, Charles P Quesenberry, Wayne D Rosamond, David H Smith, Jeffrey J VanWormer, Suma Vupputuri, Stephen C Waring, Marc S Williams, Stephen Sidney
BACKGROUND: Monitoring trends in cardiovascular events can provide key insights into the effectiveness of prevention efforts. Leveraging data from electronic health records provides a unique opportunity to examine contemporary, community-based trends in acute myocardial infarction hospitalizations. METHODS: We examined trends in hospitalized acute myocardial infarction incidence among adults aged ≥25 years in 13 U.S. health plans in the Cardiovascular Research Network...
October 14, 2016: American Journal of Medicine
Mahmoud Al Rifai, Jaideep Patel, Rupert K Hung, Khurram Nasir, Steven J Keteyian, Clinton A Brawner, Jonathan K Ehrman, Sherif Sakr, Roger S Blumenthal, Michael J Blaha, Mouaz H Al-Mallah
BACKGROUND: Cardiorespiratory fitness protects against mortality; however, little is known about the benefits of improved fitness in individuals with a family history of coronary heart disease. We studied the association between cardiorespiratory fitness and risk of incident coronary heart disease and all-cause mortality, hypothesizing an inverse relationship similar to individuals without a family history of coronary heart disease. METHODS: We included 57,999 patients (53±13 years; 49% females; 29% Black), from the Henry Ford Exercise Testing (FIT) Project...
October 14, 2016: American Journal of Medicine
Erica Lin, Isabel A Hujoel, Thomas G Mason
This manuscript describes an original case report with key words adult-onset Still's Disease and fever curve. It is not under consideration for submission or publication by any other journal. All authors contributed to the preparation of this manuscript. All authors approved the manuscript and this submission and can be reached through the email addresses, listed below. All authors declare that they have no conflicts of interest. The authors report no proprietary or commercial interest in any product mentioned or concept discussed in this article...
October 14, 2016: American Journal of Medicine
G Caleb Alexander, Geetha Iyer, Eleanor Lucas, Dora Lin, Sonal Singh
PURPOSE: We sought to evaluate whether exogenous testosterone therapy is associated with increased risk of serious cardiovascular events as compared to other treatments or placebo. METHODS: Study selection included randomized controlled trials (RCTs) and observational studies which enrolled men aged 18 years or older receiving exogenous testosterone for three or more days were included. The primary outcomes were death due to all causes, myocardial infarction and stroke...
October 14, 2016: American Journal of Medicine
Giulia Renda, Fabrizio Ricci, Raffaele De Caterina
BACKGROUND: Non-vitamin K oral anticoagulants (NOACs) are now proven alternatives to vitamin K antagonists (VKAs) for stroke prevention in atrial fibrillation (AF). However, there are few data on the efficacy and safety of their use around cardioversion, where the risk of thromboembolic events is heightened. METHODS: We performed a random-effects meta-analysis of patients undergoing both electrical and pharmacological cardioversion for AF in the RE-LY, ROCKET-AF, ARISTOTLE, ENGAGE AF-TIMI 48, X-VeRT and ENSURE-AF trials...
October 14, 2016: American Journal of Medicine
Zachary R Noel, Craig J Beavers
Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) inhibitors serve as a valuable addition to the armamentarium of lipid lowering agents and have promising potential. By inhibiting the PCSK9 enzyme, this novel molecule leads to increase low density lipoprotiein (LDL) receptor density and decreased circulation of LDL. The fact the agent is a monoclonal antibody has led to limited drug interactions and minimized adverse drug events. It is critical for all providers to have a basic understanding of these novel therapies with their introduction and use for treatment...
October 14, 2016: American Journal of Medicine
Jerome Greenberg
No abstract text is available yet for this article.
October 13, 2016: American Journal of Medicine
Elisa Pose, Elsa Solà, Salvatore Piano, Elisabetta Gola, Isabel Graupera, Mónica Guevara, Andrés Cárdenas, Paolo Angeli, Pere Ginès
BACKGROUND: Vaptans, vasopressin selective V2-receptor antagonist, represent the first pharmacological approach to the treatment of hypervolemic hyponatremia in cirrhosis. However, information on the use of vaptans for patients with cirrhosis and hyponatremia in a real-life scenario is very limited. Therefore, this study evaluated the effect of tolvaptan on serum sodium in patients with cirrhosis and severe hypervolemic hyponatremia. METHODS: Nine patients with cirrhosis and serum sodium <125mEq/L were included...
October 13, 2016: American Journal of Medicine
Michał Mazurek, Menno V Huisman, Gregory Y H Lip
BACKGROUND: Recent improvements in atrial fibrillation diagnosis and management have prompted the initiation of various registries, predominantly to assess adherence to new guidelines, but also to address the pending questions of safety and effectiveness of newly introduced management options in 'real world' clinical practice settings. In this review we appraise antithrombotic treatment patterns for stroke prevention in atrial fibrillation registries. METHODS AND RESULTS: We searched PubMed, Science Direct and the Cochrane databases for registries focusing on stroke thromboprophylaxis in atrial fibrillation...
October 13, 2016: American Journal of Medicine
Jerome Greenberg
No abstract text is available yet for this article.
October 13, 2016: American Journal of Medicine
Ami Schattner, Steven R Simon
No abstract text is available yet for this article.
October 13, 2016: American Journal of Medicine
Barry J Maron, Ethan J Rowin, Martin S Maron, Eugene Braunwald
Hypertrophic cardiomyopathy was first recognized as a disease of obstruction to left ventricular outflow, hence its early names and acronyms such as idiopathic hypertrophic subaortic obstruction. The nonobstructive subset of patients, incapable of developing mechanical impedance to left ventricular outflow at rest or with physiologic exercise, was initially recognized by the Braunwald group at the National Institutes of Health >50 years ago in the pre-imaging era and is now recognized as comprising about one-third of hypertrophic cardiomyopathy patients...
October 13, 2016: American Journal of Medicine
Stephen J Balevic, Ankoor Shah
No abstract text is available yet for this article.
October 11, 2016: American Journal of Medicine
Satvinder Singh Bakshi
No abstract text is available yet for this article.
October 11, 2016: American Journal of Medicine
Nicolas Faller, Andreas Limacher, Marie Méan, Marc Righini, Markus Aschwanden, Jürg Hans Beer, Beat Frauchiger, Josef Osterwalder, Nils Kucher, Bernhard Lämmle, Jacques Cornuz, Anne Angelillo-Scherrer, Christian M Matter, Marc Husmann, Martin Banyai, Daniel Staub, Lucia Mazzolai, Olivier Hugli, Nicolas Rodondi, Drahomir Aujesky
BACKGROUND: Long-term predictors and causes of death are understudied in elderly patients with acute venous thromboembolism. METHODS: We prospectively followed-up 991 patients aged ≥65 years with acute venous thromboembolism in a multicenter Swiss cohort study. The primary outcome was overall mortality. We explored the association between patient baseline characteristics and mortality, adjusting for other baseline variables and periods of anticoagulation as a time-varying co-variate...
October 11, 2016: American Journal of Medicine
Kevin Chang, Chio Yokose, Craig Tenner, Cheongeun Oh, Robert Donnino, Alana Choy-Shan, Virginia C Pike, Binita D Shah, Jeffrey D Lorin, Svetlana Krasnokutsky, Steven P Sedlis, Michael H Pillinger
BACKGROUND: An independent association between gout and coronary artery disease is well established. The relationship between gout and valvular heart disease, however, is unclear. The aim of this study was to assess the association between gout and aortic stenosis. METHODS: We performed a retrospective case-control study. Aortic stenosis cases were identified through a review of outpatient transthoracic echocardiography (TTE) reports. Age-matched controls were randomly selected from patients who had undergone TTE and did not have aortic stenosis...
October 6, 2016: American Journal of Medicine
Devyani Misra, Christine Peloquin, Douglas P Kiel, Tuhina Neogi, Na Lu, Yuqing Zhang
PURPOSE: Nitrates, commonly used anti-anginal medications, also have beneficial effect on bone remodeling and bone density, particularly with intermittent use. However, their effect on fracture risk is not clear. We examined the relation of short-acting nitrate use (proxy for intermittent use) to the risk of hip fracture in a large cohort of older adults with ischemic heart disease. MATERIALS AND METHODS: Participants ≥ 60 years old with ischemic heart disease and without history of hip fracture from The Health Improvement Network (THIN), an electronic medical records database in the UK, were included...
October 6, 2016: American Journal of Medicine
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