Pub Date : 2024-12-01DOI: 10.1016/j.jnma.2023.07.001
Heba Hussein , Adel Rizkalla , Jezelle Sonnier , Ronald S. Brown
Burning Mouth syndrome (BMS) is a relatively common oral neurosensory disorder known for oral burning pain. In that there is a relative absence of oral clinical findings and systemic causation, the diagnosis of BMS is challenging. Sialadenitis of the anterior mandibular vestibule appears to be a subset of BMS. The lip component of chronic orofacial pain is potentially an important concern with regard to the diagnosis and treatment of chronic orofacial pain. Discussion regarding the etiology, diagnosis, and therapy of this condition is provided.
{"title":"Sialadenitis of the anterior mandibular vestibule: A subset of burning mouth syndrome","authors":"Heba Hussein , Adel Rizkalla , Jezelle Sonnier , Ronald S. Brown","doi":"10.1016/j.jnma.2023.07.001","DOIUrl":"10.1016/j.jnma.2023.07.001","url":null,"abstract":"<div><div><span><span>Burning Mouth syndrome (BMS) is a relatively common oral neurosensory disorder known for oral burning pain. In that there is a relative absence of oral clinical findings and systemic causation, the diagnosis of BMS is challenging. </span>Sialadenitis of the anterior mandibular </span>vestibule<span> appears to be a subset of BMS. The lip component of chronic orofacial pain is potentially an important concern with regard to the diagnosis and treatment of chronic orofacial pain. Discussion regarding the etiology, diagnosis, and therapy of this condition is provided.</span></div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 6","pages":"Pages 642-645"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9924931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardiovascular disease (CVD) remains the leading cause of death among adults in the United States. There has been significant advancement in the diagnosis and treatment of atherosclerotic cardiovascular disease (ASCVD) and its underlying risk factors. In certain populations, there remains a significant residual risk despite adequate lowering of low-density lipoprotein cholesterol (LDL-C) and control of traditional risk factors. This has led to an interest in research to identify additional risk factors that contribute to atherosclerotic cardiovascular disease. Elevated lipoprotein (a) [Lp(a)] has been identified as an independent risk factor contributing to an increased risk for CVD. There are also ethnic and racial disparities in Lp(a) inheritance that need to be understood. This paper reviews the current literature on lipoprotein a, proposed mechanisms of actions for cardiovascular disease, recommendations for testing, and the current and emerging therapies for lowering Lp(a).
心血管疾病（CVD）仍然是美国成年人的主要死因。动脉粥样硬化性心血管疾病（ASCVD）及其潜在风险因素的诊断和治疗取得了重大进展。在某些人群中，尽管适当降低了低密度脂蛋白胆固醇（LDL-C）并控制了传统的风险因素，但仍然存在很大的残余风险。因此，研究人员开始关注如何找出导致动脉粥样硬化性心血管疾病的其他风险因素。脂蛋白（a）[Lp（a）]升高已被确定为导致心血管疾病风险增加的独立风险因素。此外，脂蛋白（a）的遗传还存在民族和种族差异，需要加以了解。本文回顾了有关脂蛋白 a 的现有文献、心血管疾病的拟议作用机制、检测建议以及降低脂蛋白 a 的现有和新兴疗法。
{"title":"Lp(a) and risk of cardiovascular disease – A review of existing evidence and emerging concepts","authors":"Manasa Jasti , Sabrina Islam , Nathan Steele , Kendra Ivy , Willibroad Maimo , Ijeoma Isiadinso","doi":"10.1016/j.jnma.2023.11.009","DOIUrl":"10.1016/j.jnma.2023.11.009","url":null,"abstract":"<div><div><span>Cardiovascular disease (CVD) remains the leading cause of death among adults in the United States. There has been significant advancement in the diagnosis and treatment of atherosclerotic cardiovascular disease<span> (ASCVD) and its underlying risk factors. In certain populations, there remains a significant residual risk despite adequate lowering of low-density lipoprotein cholesterol (LDL-C) and control of traditional risk factors. This has led to an interest in research to identify additional risk factors that contribute to atherosclerotic cardiovascular disease. Elevated lipoprotein (a) [Lp(a)] has been identified as an independent risk factor contributing to an increased risk for CVD. There are also ethnic and </span></span>racial disparities<span> in Lp(a) inheritance that need to be understood. This paper reviews the current literature on lipoprotein a, proposed mechanisms of actions for cardiovascular disease, recommendations for testing, and the current and emerging therapies for lowering Lp(a).</span></div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 5","pages":"Pages 508-516"},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139033144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The beacon of hope program: Co-creating effective, measurable solutions for health equity","authors":"Priscilla Pemu , Celia Maxwell , Rajbir Singh , Jaydutt Vadgama , Shahanaz Arjumand , Linda Armstrong","doi":"10.1016/j.jnma.2024.09.002","DOIUrl":"10.1016/j.jnma.2024.09.002","url":null,"abstract":"","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 5","pages":"Pages 566-568"},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142485017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.jnma.2024.09.004
Amie A. Ogunsakin , Tomilola I. Olakunde , Moses D. Fehintola , Ifeoluwa Malmberg , Akinwale Olakunde , Ayotunde O. Dokun
Obesity is now recognized as a chronic, progressive condition requiring early intervention and long-term management to achieve health benefits and improve metabolic risk factors. The main objective of obesity pharmacotherapy is weight loss and weight loss maintenance. There is increasing acceptance of anti-obesity medications as an adjunct to lifestyle modifications and/or surgery. In recent years there has been an evolution in management approach and pharmacologic options for treatment. As a result, there is increased focus on the efficacy and safety of these agents. We provide a historical perspective, review of recent studies on anti-obesity medication outcomes showing efficacy, potential side effects and promising therapies in development.
{"title":"Updates in pharmacotherapy of obesity","authors":"Amie A. Ogunsakin , Tomilola I. Olakunde , Moses D. Fehintola , Ifeoluwa Malmberg , Akinwale Olakunde , Ayotunde O. Dokun","doi":"10.1016/j.jnma.2024.09.004","DOIUrl":"10.1016/j.jnma.2024.09.004","url":null,"abstract":"<div><div>Obesity is now recognized as a chronic, progressive condition requiring early intervention and long-term management to achieve health benefits and improve metabolic risk factors. The main objective of obesity pharmacotherapy is weight loss and weight loss maintenance. There is increasing acceptance of anti-obesity medications as an adjunct to lifestyle modifications and/or surgery. In recent years there has been an evolution in management approach and pharmacologic options for treatment. As a result, there is increased focus on the efficacy and safety of these agents. We provide a historical perspective, review of recent studies on anti-obesity medication outcomes showing efficacy, potential side effects and promising therapies in development.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 5","pages":"Pages 576-587"},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hypertension is the predominant risk factor for cardiovascular disease related morbidity and mortality among Black adults in the United States. It contributes significantly to the development of heart failure and increases the risk of death following heart failure diagnosis. It is also a leading predisposing factor for hypertensive disorders of pregnancy and peripartum cardiomyopathy in Black women. As such, all stakeholders including health care providers, particularly primary care clinicians (including physicians and advanced practice providers), patients, and communities must be aware of the consequences of uncontrolled hypertension among Black adults. Appropriate treatment strategies should be identified and implemented to ensure timely and effective blood pressure management among Black individuals, particularly those with, and at risk for heart failure.
{"title":"Managing hypertension in African Americans with heart failure: A guide for the primary care clinician","authors":"Bria Rice , Lydia Mbatidde , Oludamilola Oluleye , Anekwe Onwuanyi , Demilade Adedinsewo","doi":"10.1016/j.jnma.2023.11.004","DOIUrl":"10.1016/j.jnma.2023.11.004","url":null,"abstract":"<div><div>Hypertension is the predominant risk factor for cardiovascular disease related morbidity and mortality among Black adults in the United States. It contributes significantly to the development of heart failure and increases the risk of death following heart failure diagnosis. It is also a leading predisposing factor for hypertensive disorders of pregnancy and peripartum cardiomyopathy<span> in Black women. As such, all stakeholders including health care providers, particularly primary care clinicians (including physicians and advanced practice providers), patients, and communities must be aware of the consequences of uncontrolled hypertension among Black adults. Appropriate treatment strategies should be identified and implemented to ensure timely and effective blood pressure management among Black individuals, particularly those with, and at risk for heart failure.</span></div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 5","pages":"Pages 477-489"},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138505058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.jnma.2024.10.004
Marie L. Borum MD, EdD, MPH, MACP, FACG, AGAF, FRCP (Editor-In-Chief, Journal of the National Medical Association)
{"title":"Special Issue on Cardiovascular Health in African-Americans and More","authors":"Marie L. Borum MD, EdD, MPH, MACP, FACG, AGAF, FRCP (Editor-In-Chief, Journal of the National Medical Association)","doi":"10.1016/j.jnma.2024.10.004","DOIUrl":"10.1016/j.jnma.2024.10.004","url":null,"abstract":"","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 5","pages":"Page 465"},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142690269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.jnma.2023.11.008
JaNae’ Richard , Jacob Sama , Anekwe Onwuanyi , Onyedika J. Ilonze
Black patients develop heart failure at younger ages and have worse outcomes such as higher mortality rates compared to other racial and ethnic groups in the United States. Despite significant recent improvements in heart failure medical therapy, these worse outcomes have persisted. Multiple reasons have been provided to explain the situation, including but not limited to higher baseline cluster of cardiovascular risk factors amongst Black patients, inadequate use of heart failure guideline directed medical therapy and delayed referral for advanced heart failure therapies and interventions. Strategic interventions considering social and structural determinants of health, addressing structural inequalities/ bias, implementation of quality improvement programs, early diagnosis and prevention are critically needed to bridge the racial/ ethnic disparities gap and improve longevity of Black patients with heart failure. In this review, we propose evidence-based solutions that provide a framework for the primary care physician addressing these challenges to engender equity in treatment allocation and improve outcomes for all patients with heart failure.
{"title":"Top five considerations for improving outcomes in black patients with heart failure: A guide for primary care clinicians","authors":"JaNae’ Richard , Jacob Sama , Anekwe Onwuanyi , Onyedika J. Ilonze","doi":"10.1016/j.jnma.2023.11.008","DOIUrl":"10.1016/j.jnma.2023.11.008","url":null,"abstract":"<div><div>Black patients develop heart failure at younger ages and have worse outcomes such as higher mortality rates compared to other racial and ethnic groups in the United States. Despite significant recent improvements in heart failure medical therapy, these worse outcomes have persisted. Multiple reasons have been provided to explain the situation, including but not limited to higher baseline cluster of cardiovascular risk factors amongst Black patients, inadequate use of heart failure guideline directed medical therapy and delayed referral for advanced heart failure therapies and interventions. Strategic interventions considering social and structural determinants of health, addressing structural inequalities/ bias, implementation of quality improvement programs, early diagnosis and prevention are critically needed to bridge the racial/ ethnic disparities gap and improve longevity of Black patients with heart failure. In this review, we propose evidence-based solutions that provide a framework for the primary care physician addressing these challenges to engender equity in treatment allocation and improve outcomes for all patients with heart failure.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 5","pages":"Pages 499-507"},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138541409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.jnma.2023.11.007
Hakeem Ayinde , Favour Markson , Ugonna Kevin Ogbenna , Larry Jackson II
Atrial fibrillation (AF) is the most common sustained arrhythmia, affecting between 3 and 6 million people in the United States. It is associated with a reduced quality of life and increased risk of stroke, cognitive decline, heart failure and death. Black patients have a lower prevalence of AF than White patients but are more likely to suffer worse outcomes with the disease. It is important that stakeholders understand the disproportionate burden of disease and management gaps that exists among Black patients living with AF. Appropriate treatments, including aggressive risk factor control, early referral to cardiovascular specialists and improving healthcare access may bridge some of the gaps in management and improve outcomes.
{"title":"Addressing racial differences in the management of atrial fibrillation: Focus on black patients","authors":"Hakeem Ayinde , Favour Markson , Ugonna Kevin Ogbenna , Larry Jackson II","doi":"10.1016/j.jnma.2023.11.007","DOIUrl":"10.1016/j.jnma.2023.11.007","url":null,"abstract":"<div><div>Atrial fibrillation<span> (AF) is the most common sustained arrhythmia<span>, affecting between 3 and 6 million people in the United States. It is associated with a reduced quality of life and increased risk of stroke, cognitive decline, heart failure and death. Black patients have a lower prevalence of AF than White patients but are more likely to suffer worse outcomes with the disease. It is important that stakeholders understand the disproportionate burden of disease and management gaps that exists among Black patients living with AF. Appropriate treatments, including aggressive risk factor control, early referral to cardiovascular specialists and improving healthcare access may bridge some of the gaps in management and improve outcomes.</span></span></div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 5","pages":"Pages 490-498"},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138541445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.jnma.2024.10.011
{"title":"Leonidas H. Berry Health Equity Research Award - ACG Announcement","authors":"","doi":"10.1016/j.jnma.2024.10.011","DOIUrl":"10.1016/j.jnma.2024.10.011","url":null,"abstract":"","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 5","pages":"Pages 626-631"},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142697808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.jnma.2024.09.003
Milena Bastos Brito , Andrea Queiroz Vilas Boas , Anelise Maria Nicolau Silva , Flávia Pimentel Miranda , Carolina Brabec Barreto Matos , Oziemile Silva Santos , Tais Paiva da Costa
Background
Sickle cell disease is a hereditary hemolytic anemia that exposes women to increased health risks especially in pregnancy, with serious implications for the woman and fetus. Acute pain episodes can occur multiple times per month and result in reduction of quality of life and disruption of her life.
Objective
To assess the clinical, including pain and metabolic parameters of women with sickle cell disease using etonogestrel-releasing contraceptive implants.
Methods
Women with sickle cell disease, aged 18–40 years, with reports of pain crises in the preceding 3 months were included and followed up for 12 months. Blood samples were collected to evaluate the blood count, reticulocytes, liver profile (alkaline phosphatase, gamma-glutamyl transferase, alanine aminotransferase, aspartate aminotransferase, and total bilirubin and its fractions), lipid profile, and lactate dehydrogenase levels before and 6 and 12 months after implant insertion. The following clinical variables were analyzed every 3 months: bleeding pattern, blood pressure, weight, body mass index, pain intensity (assessed using a visual analogic scale (VAS) from 0 to 10), and frequency of pain crises.
Results
Twenty-three women completed the study. There were no differences in laboratory variables between baseline and 6 and 12 months after implant insertion. Similarly, clinical variables did not differ, except for pain intensity (VAS pre-insertion = 8 vs. VAS 12 months post insertion = 4; p = 0.005) and frequency of pain crises (pre-insertion = 6 vs. 12 days/month post insertion = 0; p = 0.000).
Conclusions
Etonogestrel-releasing contraceptive implants were associated with a reduction in the intensity and frequency of pain crises in women with sickle cell disease. Moreover, it was safety among these population due to no changes in laboratory parameters during the first 12 months of use.
{"title":"Impact of Etonogestrel-releasing contraceptive implant use in cisgender women with Sickle cell disease","authors":"Milena Bastos Brito , Andrea Queiroz Vilas Boas , Anelise Maria Nicolau Silva , Flávia Pimentel Miranda , Carolina Brabec Barreto Matos , Oziemile Silva Santos , Tais Paiva da Costa","doi":"10.1016/j.jnma.2024.09.003","DOIUrl":"10.1016/j.jnma.2024.09.003","url":null,"abstract":"<div><h3>Background</h3><div>Sickle cell disease is a hereditary hemolytic anemia that exposes women to increased health risks especially in pregnancy, with serious implications for the woman and fetus. Acute pain episodes can occur multiple times per month and result in reduction of quality of life and disruption of her life.</div></div><div><h3>Objective</h3><div>To assess the clinical, including pain and metabolic parameters of women with sickle cell disease using etonogestrel-releasing contraceptive implants.</div></div><div><h3>Methods</h3><div>Women with sickle cell disease, aged 18–40 years, with reports of pain crises in the preceding 3 months were included and followed up for 12 months. Blood samples were collected to evaluate the blood count, reticulocytes, liver profile (alkaline phosphatase, gamma-glutamyl transferase, alanine aminotransferase, aspartate aminotransferase, and total bilirubin and its fractions), lipid profile, and lactate dehydrogenase levels before and 6 and 12 months after implant insertion. The following clinical variables were analyzed every 3 months: bleeding pattern, blood pressure, weight, body mass index, pain intensity (assessed using a visual analogic scale (VAS) from 0 to 10), and frequency of pain crises.</div></div><div><h3>Results</h3><div>Twenty-three women completed the study. There were no differences in laboratory variables between baseline and 6 and 12 months after implant insertion. Similarly, clinical variables did not differ, except for pain intensity (VAS pre-insertion = 8 vs. VAS 12 months post insertion = 4; p = 0.005) and frequency of pain crises (pre-insertion = 6 vs. 12 days/month post insertion = 0; p = 0.000).</div></div><div><h3>Conclusions</h3><div>Etonogestrel-releasing contraceptive implants were associated with a reduction in the intensity and frequency of pain crises in women with sickle cell disease. Moreover, it was safety among these population due to no changes in laboratory parameters during the first 12 months of use.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 5","pages":"Pages 569-575"},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142485016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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