Pub Date : 2026-06-01Epub Date: 2026-02-20DOI: 10.1016/j.jnma.2026.02.004
Jhonsley Frederic , Vicki Oladoyin , Jagannathan Geetha , Ayanna Muhammad , Ralph Wehmer , Ayomide Sowemimo , Sri Lakshmi Kollepara
Primary adenocarcinoma of the urinary bladder is the rarest form of urinary tract malignancy, accounting for less than 2% of bladder cancers in the United States. Adenocarcinomas of the bladder are extremely rare, with distinct histological features, and, due to their morphological similarity to colorectal adenocarcinoma, they pose a diagnostic challenge. We report the case of a 62-year-old male with a significant history of tobacco use who presented with gross hematuria and irritative voiding symptoms. Imaging revealed a mass involving the posterior and inferior bladder wall, and biopsy confirmed invasive bladder adenocarcinoma. Immunochemistry supported a primary bladder origin (CK7-, CK20+, CDX2+, positive membranous β-catenin). The patient declined radical cystectomy in favor of bladder-sparing trimodality therapy. He remained recurrence-free for five years before developing locally invasive recurrence requiring systemic chemotherapy. This case highlights the importance of distinguishing primary bladder adenocarcinoma from secondary colorectal involvement, emphasizing the need for care to be adapted to a patient’s changing clinical needs.
{"title":"Primary Enteric-type adenocarcinoma of the bladder managed with colon-type chemotherapy: A rare case and literature review","authors":"Jhonsley Frederic , Vicki Oladoyin , Jagannathan Geetha , Ayanna Muhammad , Ralph Wehmer , Ayomide Sowemimo , Sri Lakshmi Kollepara","doi":"10.1016/j.jnma.2026.02.004","DOIUrl":"10.1016/j.jnma.2026.02.004","url":null,"abstract":"<div><div>Primary adenocarcinoma of the urinary bladder is the rarest form of urinary tract malignancy, accounting for less than 2% of bladder cancers in the United States. Adenocarcinomas of the bladder are extremely rare, with distinct histological features, and, due to their morphological similarity to colorectal adenocarcinoma, they pose a diagnostic challenge. We report the case of a 62-year-old male with a significant history of tobacco use who presented with gross hematuria and irritative voiding symptoms. Imaging revealed a mass involving the posterior and inferior bladder wall, and biopsy confirmed invasive bladder adenocarcinoma. Immunochemistry supported a primary bladder origin (CK7-, CK20+, CDX2+, positive membranous β-catenin). The patient declined radical cystectomy in favor of bladder-sparing trimodality therapy. He remained recurrence-free for five years before developing locally invasive recurrence requiring systemic chemotherapy. This case highlights the importance of distinguishing primary bladder adenocarcinoma from secondary colorectal involvement, emphasizing the need for care to be adapted to a patient’s changing clinical needs.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"118 3","pages":"Pages 442-445"},"PeriodicalIF":2.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147438962","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 : 2026-06-01Epub Date: 2026-03-23DOI: 10.1016/j.jnma.2026.03.003
Christopher L. Smyre , Carl Earl Lambert Jr. , Kendall M. Campbell
Pseudoleadership poses a threat to faculty leadership and can be a concern among early career faculty in academic medicine due to their early career appointments and limited experience in their work roles. Pseudoleadership is defined as being placed in a leadership position and not provided adequate training, resources or the institutional equity to successfully perform in the leadership role. Having impacts on learners, including those who are minoritized, early career faculty can be pseudoleaders when they are not adequately trained or equipped to manage the education needs of minoritized medical students. In this perspectives article the authors further characterize pseudoleadership on learning for minoritized students from the perspectives of classroom and clinical spaces and propose an actionable path forward for faculty and leaders in academic medicine.
{"title":"Impacts of pseudoleadership on learning in medical school","authors":"Christopher L. Smyre , Carl Earl Lambert Jr. , Kendall M. Campbell","doi":"10.1016/j.jnma.2026.03.003","DOIUrl":"10.1016/j.jnma.2026.03.003","url":null,"abstract":"<div><div>Pseudoleadership poses a threat to faculty leadership and can be a concern among early career faculty in academic medicine due to their early career appointments and limited experience in their work roles. Pseudoleadership is defined as being placed in a leadership position and not provided adequate training, resources or the institutional equity to successfully perform in the leadership role. Having impacts on learners, including those who are minoritized, early career faculty can be pseudoleaders when they are not adequately trained or equipped to manage the education needs of minoritized medical students. In this perspectives article the authors further characterize pseudoleadership on learning for minoritized students from the perspectives of classroom and clinical spaces and propose an actionable path forward for faculty and leaders in academic medicine.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"118 3","pages":"Pages 489-493"},"PeriodicalIF":2.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147518056","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 : 2026-06-01Epub Date: 2026-05-07DOI: 10.1016/j.jnma.2026.04.006
Tong Liu , Zhaojie Meng , Dan Li , Bing Hu , Yanxiang Sun , Yuanya Liu , Yanchun Zhang , Li Feng
Background
Glycemic variability (GV) may indicate underlying cardiovascular complications, but its association with atrial fibrillation (AF) in acute myocardial infarction (AMI) remains unclear. Therefore, this study aimed to assess the association between GV and the risk of AF in patients hospitalized with AMI.
Methods
We analyzed 10,439 patients with AMI from the MIMIC-IV database (17 % STEMI, 61 % NSTEMI). The median age was 71 years (interquartile range: 61–80), and 27 % of patients underwent invasive treatment. GV was calculated based on post-admission plasma glucose levels (SD/mean glucose × 100 %). Outcomes included AF detection and in-hospital mortality, analyzed via multivariable logistic regression and restricted cubic spline (RCS) models.
Results
Among participants, 16.2 % developed AF, with incidence rising across GV quartiles (highest vs. lowest: 21 % vs. 7.1 %, p < 0.001). After adjustment, a higher GV was independently associated with AF (OR: 2.41, 95 % CI: 1.40–4.14, p = 0.002) and mortality (OR: 2.45, 95 % CI: 1.37–4.38, p = 0.002). Subgroup analyses confirmed consistent results, and RCS revealed nonlinear relationships (P-nonlinear<0.05). Notably, the predictive power of GV persisted in individuals without diabetes, as well as in the White (OR: 8.195, 95 % CI: 5.637−11.914, p < 0.001) and in non-White (OR: 2.697, 95 % CI: 1.587–4.586, p < 0.001) patients. Significant interactions were identified between GV and both ethnicity and heart failure status (all interaction p < 0.05). However, these results must be interpreted with caution due to potential bias.
Conclusion
Elevated GV may be associated with the risk of AF and mortality in AMI patients, even without diabetes and in Whites. These findings should be validated in other cohort studies with larger numbers of non-White people and longer follow-up.
{"title":"The association between glycemic variability and atrial fibrillation/in-hospital mortality in white and non-white patients with acute myocardial infarction: A retrospective cohort study","authors":"Tong Liu , Zhaojie Meng , Dan Li , Bing Hu , Yanxiang Sun , Yuanya Liu , Yanchun Zhang , Li Feng","doi":"10.1016/j.jnma.2026.04.006","DOIUrl":"10.1016/j.jnma.2026.04.006","url":null,"abstract":"<div><h3>Background</h3><div>Glycemic variability (GV) may indicate underlying cardiovascular complications, but its association with atrial fibrillation (AF) in acute myocardial infarction (AMI) remains unclear. Therefore, this study aimed to assess the association between GV and the risk of AF in patients hospitalized with AMI.</div></div><div><h3>Methods</h3><div>We analyzed 10,439 patients with AMI from the MIMIC-IV database (17 % STEMI, 61 % NSTEMI). The median age was 71 years (interquartile range: 61–80), and 27 % of patients underwent invasive treatment. GV was calculated based on post-admission plasma glucose levels (SD/mean glucose × 100 %). Outcomes included AF detection and in-hospital mortality, analyzed via multivariable logistic regression and restricted cubic spline (RCS) models.</div></div><div><h3>Results</h3><div>Among participants, 16.2 % developed AF, with incidence rising across GV quartiles (highest vs. lowest: 21 % vs. 7.1 %, <em>p</em> < 0.001). After adjustment, a higher GV was independently associated with AF (OR: 2.41, 95 % CI: 1.40–4.14, <em>p</em> = 0.002) and mortality (OR: 2.45, 95 % CI: 1.37–4.38, <em>p</em> = 0.002). Subgroup analyses confirmed consistent results, and RCS revealed nonlinear relationships (P-nonlinear<0.05). Notably, the predictive power of GV persisted in individuals without diabetes, as well as in the White (OR: 8.195, 95 % CI: 5.637−11.914, <em>p</em> < 0.001) and in non-White (OR: 2.697, 95 % CI: 1.587–4.586, <em>p</em> < 0.001) patients. Significant interactions were identified between GV and both ethnicity and heart failure status (all interaction <em>p</em> < 0.05). However, these results must be interpreted with caution due to potential bias.</div></div><div><h3>Conclusion</h3><div>Elevated GV may be associated with the risk of AF and mortality in AMI patients, even without diabetes and in Whites. These findings should be validated in other cohort studies with larger numbers of non-White people and longer follow-up.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"118 3","pages":"Pages 422-433"},"PeriodicalIF":2.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857996","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 : 2026-02-01Epub Date: 2025-11-12DOI: 10.1016/j.jnma.2025.11.006
Mireille Bright , Alex Grant , Jialing Zhu , Aisha Choudhri , Chiranjeev Dash , Lucile Adams-Campbell
Background
Black immigrants will make up one-third of the U.S. Black population by 2060. Despite numerous studies on cancer burdens and cancer screening behaviors in the Black population, very limited information exists on these factors within the Black immigrant population. This study aims to report breast, cervical, colorectal, lung, and prostate cancer screening rates among Black immigrants residing in the Washington, D.C. metropolitan area and to compare cancer screening differences with U.S.-born Blacks.
Methods
Participants were asked to complete a survey designed to assess cancer-preventative screening practices among African and Afro-Caribbean immigrants residing in the Washington, D.C. metropolitan area.
Results
The study population comprised 105 Black immigrants. Screening for colorectal, prostate, and lung cancers was low. Approximately 70% of Black immigrant men reported never having a colorectal or prostate cancer screening exam. However, Black immigrant women had relatively high rates of breast and cervical cancer screening, 76% and 71%, respectively. When compared to U.S.-born Black Americans, Black immigrants were screened at lower rates for all studied cancers except lung cancer.
Conclusion
Prostate, colorectal, and lung cancer screening rates are remarkably low, especially among Black immigrant men. Black immigrant women have relatively high screening rates for women-specific cancers. This study emphasizes the importance of the need for greater cancer education and prevention strategies within the Black immigrant community.
{"title":"Preventative cancer screening among African and Afro-Caribbean immigrants","authors":"Mireille Bright , Alex Grant , Jialing Zhu , Aisha Choudhri , Chiranjeev Dash , Lucile Adams-Campbell","doi":"10.1016/j.jnma.2025.11.006","DOIUrl":"10.1016/j.jnma.2025.11.006","url":null,"abstract":"<div><h3>Background</h3><div>Black immigrants will make up one-third of the U.S. Black population by 2060. Despite numerous studies on cancer burdens and cancer screening behaviors in the Black population, very limited information exists on these factors within the Black immigrant population. This study aims to report breast, cervical, colorectal, lung, and prostate cancer screening rates among Black immigrants residing in the Washington, D.C. metropolitan area and to compare cancer screening differences with U.S.-born Blacks.</div></div><div><h3>Methods</h3><div>Participants were asked to complete a survey designed to assess cancer-preventative screening practices among African and Afro-Caribbean immigrants residing in the Washington, D.C. metropolitan area.</div></div><div><h3>Results</h3><div>The study population comprised 105 Black immigrants. Screening for colorectal, prostate, and lung cancers was low. Approximately 70% of Black immigrant men reported never having a colorectal or prostate cancer screening exam. However, Black immigrant women had relatively high rates of breast and cervical cancer screening, 76% and 71%, respectively. When compared to U.S.-born Black Americans, Black immigrants were screened at lower rates for all studied cancers except lung cancer.</div></div><div><h3>Conclusion</h3><div>Prostate, colorectal, and lung cancer screening rates are remarkably low, especially among Black immigrant men. Black immigrant women have relatively high screening rates for women-specific cancers. This study emphasizes the importance of the need for greater cancer education and prevention strategies within the Black immigrant community.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"118 1","pages":"Pages 90-95"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145608204","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 : 2026-02-01Epub Date: 2025-09-30DOI: 10.1016/j.jnma.2025.09.003
L.E. Gomez
Research supports the transformational impact of Lean Six Sigma on the US healthcare system over the past two and a half decades, now commonly referred to as Lean Healthcare (LH).1 These tools have facilitated reduction in medical errors, wait times, and cost of care delivery, while increasing specific quality metrics such as patient turnover and patient satisfaction that are centered on patient safety and the reduction of medical errors.2, 3, 4, 5 Six Sigma, a term derived from manufacturing quality control indicating a process operating within ±6σ limits (∼3.4 defects per million opportunities), also has increased operational profitability, though without reducing costs for consumers or insurers.6 While outcomes serve as an approximate endpoint for improved health states, national spending continues to outpace other high-income countries without corresponding outcome gains. This review highlights lessons from wide-scale implementation of Lean Six Sigma (LSS): its impact on costs, quality metrics, and health outcomes—with attention to potential in small practices.
{"title":"Lean six sigma improves performance not outcomes: Past limitations, potential solutions","authors":"L.E. Gomez","doi":"10.1016/j.jnma.2025.09.003","DOIUrl":"10.1016/j.jnma.2025.09.003","url":null,"abstract":"<div><div>Research supports the transformational impact of Lean Six Sigma on the US healthcare system over the past two and a half decades, now commonly referred to as Lean Healthcare (LH).<span><span><sup>1</sup></span></span> These tools have facilitated reduction in medical errors, wait times, and cost of care delivery, while increasing specific quality metrics such as patient turnover and patient satisfaction that are centered on patient safety and the reduction of medical errors.<span><span>2</span></span>, <span><span>3</span></span>, <span><span>4</span></span>, <span><span>5</span></span> Six Sigma, a term derived from manufacturing quality control indicating a process operating within ±6σ limits (∼3.4 defects per million opportunities), also has increased operational profitability, though without reducing costs for consumers or insurers.<span><span><sup>6</sup></span></span> While outcomes serve as an approximate endpoint for improved health states, national spending continues to outpace other high-income countries without corresponding outcome gains. This review highlights lessons from wide-scale implementation of Lean Six Sigma (LSS): its impact on costs, quality metrics, and health outcomes—with attention to potential in small practices.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"118 1","pages":"Pages 13-17"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208914","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 : 2026-02-01Epub Date: 2026-02-02DOI: 10.1016/j.jnma.2026.01.002
Marie L. Borum MD, EdD, MPH, MACP, FACG, AGAF, FRCP (Editor-in-Chief)
{"title":"Equity, prevention, and representation in an evolving health care landscape","authors":"Marie L. Borum MD, EdD, MPH, MACP, FACG, AGAF, FRCP (Editor-in-Chief)","doi":"10.1016/j.jnma.2026.01.002","DOIUrl":"10.1016/j.jnma.2026.01.002","url":null,"abstract":"","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"118 1","pages":"Page 1"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146098687","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 : 2026-02-01Epub Date: 2025-12-04DOI: 10.1016/j.jnma.2025.11.007
Christopher K.H. Burris , Daniel M. Albert
{"title":"Black American ophthalmologists","authors":"Christopher K.H. Burris , Daniel M. Albert","doi":"10.1016/j.jnma.2025.11.007","DOIUrl":"10.1016/j.jnma.2025.11.007","url":null,"abstract":"","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"118 1","pages":"Pages 4-8"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145688887","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 : 2026-02-01Epub Date: 2025-11-14DOI: 10.1016/j.jnma.2025.11.014
Mequanent Kassa Birarra , Tesfaye Yimer Tadesse , Lidia Solomon , Abraham Adane , Zegeye Gera , Zemene Demelash Kifle
Background
Cardiovascular diseases (CVDs) are the leading cause of morbidity and mortality among patients with Type II Diabetes Mellitus (II DM) worldwide. Despite being a major cause of both mortality and morbidity, there have been insufficient studies on the prevention and control of these serious health issues in the study area. Therefore, conducting research on the knowledge, practices, and prdictors related to cardiovascular disease prevention among adults with II DM is essential.
Objective
The current study aimed to assess knowledge and practices related to CVD prevention and assess associated factors among patients with II DM attending the outpatient clinics of the University of Gondar Comprehensive and Specialized Hospital (UoGCSH).
Method
An institution-based cross-sectional study was conducted at UoGCSH from June 27, 2022, to July 27, 2022, involving 404 patients with type II DM. Data were collected through face-to-face interviews using a semi-structured questionnaire and analyzed using the Statistical Package for Social Sciences (SPSS) version 25. Descriptive analysis was applied to examine sociodemographic characteristics, the level of knowledge about CVD, and prevention practices. Multivariate and binomial logistic regression were used to assess the association between sociodemographic factors and knowledge and practices related to CVD prevention, with a significance level set at P ≤ 0.05.
Result
The findings of this study revealed that the mean age of respondents was 50.43 ± 14.25 years, ranging from 18 to 85 years, with 55.4 % of the respondents being female. The mean knowledge score regarding CVD among DM II patients was 15.9, while the mean score for CVD prevention practices was 11.8. Overall, 57.4 % of DM II patients demonstrated good practices in CVD prevention. Moreover, being uneducated (AOR = 0.115, 95 % CI = 0.032–0.421, P = 0.001), having a monthly income of <600 (AOR = 0.41, 95 % CI = 0.179–0.94, P = 0.035), and being employed (AOR = 4.08, 95 % CI = 1.12–14.197, P = 0.033) were significantly associated with knowledge of CVD prevention
Conclusion
Overall, the level of knowledge and practice related to CVD prevention among patients with type II DM at UoGCSH was insufficient and further research is needed to assess the effect of a patient education intervention on patients' knowledge.
{"title":"Knowledge, practices, and predictors of cardiovascular disease prevention among adults with type II diabetes mellitus at the university of Gondar Medical Center, Northwest Ethiopia","authors":"Mequanent Kassa Birarra , Tesfaye Yimer Tadesse , Lidia Solomon , Abraham Adane , Zegeye Gera , Zemene Demelash Kifle","doi":"10.1016/j.jnma.2025.11.014","DOIUrl":"10.1016/j.jnma.2025.11.014","url":null,"abstract":"<div><h3>Background</h3><div>Cardiovascular diseases (CVDs) are the leading cause of morbidity and mortality among patients with Type II Diabetes Mellitus (II DM) worldwide. Despite being a major cause of both mortality and morbidity, there have been insufficient studies on the prevention and control of these serious health issues in the study area. Therefore, conducting research on the knowledge, practices, and prdictors related to cardiovascular disease prevention among adults with II DM is essential.</div></div><div><h3>Objective</h3><div>The current study aimed to assess knowledge and practices related to CVD prevention and assess associated factors among patients with II DM attending the outpatient clinics of the University of Gondar Comprehensive and Specialized Hospital (UoGCSH).</div></div><div><h3>Method</h3><div>An institution-based cross-sectional study was conducted at UoGCSH from June 27, 2022, to July 27, 2022, involving 404 patients with type II DM. Data were collected through face-to-face interviews using a semi-structured questionnaire and analyzed using the Statistical Package for Social Sciences (SPSS) version 25. Descriptive analysis was applied to examine sociodemographic characteristics, the level of knowledge about CVD, and prevention practices. Multivariate and binomial logistic regression were used to assess the association between sociodemographic factors and knowledge and practices related to CVD prevention, with a significance level set at <em>P</em> ≤ 0.05.</div></div><div><h3>Result</h3><div>The findings of this study revealed that the mean age of respondents was 50.43 ± 14.25 years, ranging from 18 to 85 years, with 55.4 % of the respondents being female. The mean knowledge score regarding CVD among DM II patients was 15.9, while the mean score for CVD prevention practices was 11.8. Overall, 57.4 % of DM II patients demonstrated good practices in CVD prevention. Moreover, being uneducated (AOR = 0.115, 95 % CI = 0.032–0.421, <em>P</em> = 0.001), having a monthly income of <600 (AOR = 0.41, 95 % CI = 0.179–0.94, <em>P</em> = 0.035), and being employed (AOR = 4.08, 95 % CI = 1.12–14.197, <em>P</em> = 0.033) were significantly associated with knowledge of CVD prevention</div></div><div><h3>Conclusion</h3><div>Overall, the level of knowledge and practice related to CVD prevention among patients with type II DM at UoGCSH was insufficient and further research is needed to assess the effect of a patient education intervention on patients' knowledge.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"118 1","pages":"Pages 164-176"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679881","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 : 2026-02-01Epub Date: 2025-10-28DOI: 10.1016/j.jnma.2025.10.007
Addisu Melake , Misganaw Asmamaw Mengstie
Background
Vitamin D deficiency and vitamin D receptor (VDR) FokI gene polymorphisms have been linked to diabetic nephropathy (DN) susceptibility across diverse populations. This study aimed to evaluate their impact on DN risk among type 2 diabetes mellitus (T2DM) patients at Debre Tabor Comprehensive Specialized Hospital, Northwest Ethiopia.
Methods
A hospital-based, age- and sex-matched case-control study was conducted, involving 210 participants: 70 T2DM patients with DN, 70 T2DM patients without DN, and 70 healthy controls. To determine the related risk factors, demographic and clinical data were assessed. DNA was extracted from blood samples and subjected to polymerase chain reaction and agarose gel electrophoresis analysis to determine the FokI genotypes.
Results
Vitamin D deficiency was more prevalent in diabetic nephropathy patients compared to non-nephropathy T2DM patients and controls (OR = 5.05, 95 % CL = 2.03–12.53; P< 0.001). Additionally, both the FokI ff genotype (OR: 2.48; 95 % CL: 1.15–5.37; P = 0.020) and f allele (OR: 1.70; 95 % CL: 1.13–2.57; P = 0.010) were substantially more prevalent in diabetic nephropathy patients than in non-nephropathy T2DM patients and controls, suggesting their potential role as genetic risk factors for the development of diabetic nephropathy.
Conclusion
These findings highlight a significant association between vitamin D deficiency and diabetic nephropathy. Moreover, FokI gene polymorphisms may be clinically relevant in identifying high-risk diabetic patients for early intervention of DN in the Ethiopian population under study.
{"title":"Impact of Vitamin D deficiency and VDR FokI polymorphism on diabetic nephropathy risk in type 2 diabetes","authors":"Addisu Melake , Misganaw Asmamaw Mengstie","doi":"10.1016/j.jnma.2025.10.007","DOIUrl":"10.1016/j.jnma.2025.10.007","url":null,"abstract":"<div><h3>Background</h3><div>Vitamin D deficiency and vitamin D receptor (VDR) FokI gene polymorphisms have been linked to diabetic nephropathy (DN) susceptibility across diverse populations. This study aimed to evaluate their impact on DN risk among type 2 diabetes mellitus (T2DM) patients at Debre Tabor Comprehensive Specialized Hospital, Northwest Ethiopia.</div></div><div><h3>Methods</h3><div>A hospital-based, age- and sex-matched case-control study was conducted, involving 210 participants: 70 T2DM patients with DN, 70 T2DM patients without DN, and 70 healthy controls. To determine the related risk factors, demographic and clinical data were assessed. DNA was extracted from blood samples and subjected to polymerase chain reaction and agarose gel electrophoresis analysis to determine the <em>FokI</em> genotypes.</div></div><div><h3>Results</h3><div>Vitamin D deficiency was more prevalent in diabetic nephropathy patients compared to non-nephropathy T2DM patients and controls (OR = 5.05, 95 % CL = 2.03–12.53; <em>P</em> <em><</em> 0.001). Additionally, both the <em>FokI</em> ff genotype (OR: 2.48; 95 % CL: 1.15–5.37; <em>P</em> = 0.020) and f allele (OR: 1.70; 95 % CL: 1.13–2.57; <em>P</em> = 0.010) were substantially more prevalent in diabetic nephropathy patients than in non-nephropathy T2DM patients and controls, suggesting their potential role as genetic risk factors for the development of diabetic nephropathy.</div></div><div><h3>Conclusion</h3><div>These findings highlight a significant association between vitamin D deficiency and diabetic nephropathy. Moreover, <em>FokI</em> gene polymorphisms may be clinically relevant in identifying high-risk diabetic patients for early intervention of DN in the Ethiopian population under study.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"118 1","pages":"Pages 83-89"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145403513","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 : 2026-02-01Epub Date: 2025-12-05DOI: 10.1016/j.jnma.2025.11.003
Archie Bleyer , Jaime Estrada , Michael A. Newman , Jennifer Liu , Stuart E. Siegel , Charles R. Thomas Jr.
Background
Globally, the United States (U.S.) has the second highest firearm suicide rate among adolescents and young adults. Identification of causes and implementation of prevention strategies are urgently needed.
Methods
Firearm prevalence was assessed in U.S. jurisdictions (states and District of Columbia) using two basic proxies: the proportion of suicides by firearm based on data from Centers for Disease Control and Prevention (CDC) WONDER and WISQARS databases, and the firearm background check rates provided by the National Instant Background Check System.
Results
In the U.S., adolescents and young adults aged 10 to 24 have experienced the largest increase in firearm suicide rates from 2010–2023 among all age groups, across both sexes, and with the sharpest increase in Black females. At the jurisdiction level, the 2022–2023 firearm suicide rate in the age group showed an exponential relationship with the proportion of suicides by firearm (ANOVA F = 42.3, p <<0.001), with females exhibiting a steeper increase. Similar correlations were observed with all background checks (F = 25.6, p <<0.001) including those for handgun (F = 28.1, p <<0.001) and long gun permits (F = 58.5, p <<0.001). Males, females, non-Hispanic Whites, and non-Hispanic Blacks in the age group all showed strong exponential correlations of firearm suicide rate with the firearm prevalence proxy (17.5 < F < 41.3, each p <<0.001). Hispanics also showed a significant, though weaker, correlation (F = 7.3, p = 0.01), and in recent years, the increase in firearm suicide rates among Whites and Hispanics has slowed.
Conclusions
In the U.S., the firearm suicide rate among those aged 10 to 24 years old— the group showing the greatest increase—are exponentially correlated with several firearm prevalence indicators, including handgun and long gun permit approvals. The association holds across both sexes and most racial/ethnicity groups. These associations implicate firearm prevalence and availability in enabling, promoting, and precipitating suicide among Americans as young as 10 years old. Since most firearm suicides in the age group occur in homes, an effective solution is to reduce and prevent firearms in homes and to secure storage of those that remain, including handguns, rifles and shotguns and their ammunition.
{"title":"Jurisdiction firearm prevalence and increasing suicide in United States adolescents and young adults","authors":"Archie Bleyer , Jaime Estrada , Michael A. Newman , Jennifer Liu , Stuart E. Siegel , Charles R. Thomas Jr.","doi":"10.1016/j.jnma.2025.11.003","DOIUrl":"10.1016/j.jnma.2025.11.003","url":null,"abstract":"<div><h3>Background</h3><div>Globally, the United States (U.S.) has the second highest firearm suicide rate among adolescents and young adults. Identification of causes and implementation of prevention strategies are urgently needed.</div></div><div><h3>Methods</h3><div>Firearm prevalence was assessed in U.S. jurisdictions (states and District of Columbia) using two basic proxies: the proportion of suicides by firearm based on data from Centers for Disease Control and Prevention (CDC) WONDER and WISQARS databases, and the firearm background check rates provided by the National Instant Background Check System.</div></div><div><h3>Results</h3><div>In the U.S., adolescents and young adults aged 10 to 24 have experienced the largest increase in firearm suicide rates from 2010–2023 among all age groups, across both sexes, and with the sharpest increase in Black females. At the jurisdiction level, the 2022–2023 firearm suicide rate in the age group showed an exponential relationship with the proportion of suicides by firearm (ANOVA <em>F</em> = 42.3, <em>p</em> <<0.001), with females exhibiting a steeper increase. Similar correlations were observed with all background checks (<em>F</em> = 25.6, <em>p</em> <<0.001) including those for handgun (<em>F</em> = 28.1, <em>p</em> <<0.001) and long gun permits (<em>F</em> = 58.5, <em>p</em> <<0.001). Males, females, non-Hispanic Whites, and non-Hispanic Blacks in the age group all showed strong exponential correlations of firearm suicide rate with the firearm prevalence proxy (17.5 < <em>F</em> < 41.3, each <em>p</em> <<0.001). Hispanics also showed a significant, though weaker, correlation (<em>F</em> = 7.3, <em>p</em> = 0.01), and in recent years, the increase in firearm suicide rates among Whites and Hispanics has slowed.</div></div><div><h3>Conclusions</h3><div>In the U.S., the firearm suicide rate among those aged 10 to 24 years old— the group showing the greatest increase—are exponentially correlated with several firearm prevalence indicators, including handgun and long gun permit approvals. The association holds across both sexes and most racial/ethnicity groups. These associations implicate firearm prevalence and availability in enabling, promoting, and precipitating suicide among Americans as young as 10 years old. Since most firearm suicides in the age group occur in homes, an effective solution is to reduce and prevent firearms in homes and to secure storage of those that remain, including handguns, rifles and shotguns and their ammunition.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"118 1","pages":"Pages 113-124"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145696531","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号