Pub Date : 2024-12-11DOI: 10.1016/j.amjmed.2024.12.011
Shinichiro Inoue, Yosuke Mai, Mika Watanabe
{"title":"Visualization of patient discomfort: starch-iodine test for anhidrosis in Horner syndrome.","authors":"Shinichiro Inoue, Yosuke Mai, Mika Watanabe","doi":"10.1016/j.amjmed.2024.12.011","DOIUrl":"https://doi.org/10.1016/j.amjmed.2024.12.011","url":null,"abstract":"","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-11DOI: 10.1016/j.amjmed.2024.12.004
Yu-Ting Tsai, Han-Chi Tseng
{"title":"Generalized granuloma annulare in a patient with human immunodeficiency virus infection.","authors":"Yu-Ting Tsai, Han-Chi Tseng","doi":"10.1016/j.amjmed.2024.12.004","DOIUrl":"https://doi.org/10.1016/j.amjmed.2024.12.004","url":null,"abstract":"","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-10DOI: 10.1016/j.amjmed.2024.11.035
Laszlo Littmann
{"title":"Treatment of Drug-Induced Dermatitis and Itching with Diclofenac Gel.","authors":"Laszlo Littmann","doi":"10.1016/j.amjmed.2024.11.035","DOIUrl":"https://doi.org/10.1016/j.amjmed.2024.11.035","url":null,"abstract":"","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-10DOI: 10.1016/j.amjmed.2024.11.037
Grace E Cardenas, Linda Ren, Stephanie V Sherman
{"title":"Cortisol and Contagions: Infections in Cushing's Syndrome.","authors":"Grace E Cardenas, Linda Ren, Stephanie V Sherman","doi":"10.1016/j.amjmed.2024.11.037","DOIUrl":"https://doi.org/10.1016/j.amjmed.2024.11.037","url":null,"abstract":"","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-07DOI: 10.1016/j.amjmed.2024.11.022
Molly F MacIsaac, Jennifer Crema, Jennifer Brock, Amy Musnik, Linda Pollack, Gianna Crema, Dara Brener
{"title":"A Service-Oriented Pre-Visit Planning Model to Improve Quality Metrics in Primary Care.","authors":"Molly F MacIsaac, Jennifer Crema, Jennifer Brock, Amy Musnik, Linda Pollack, Gianna Crema, Dara Brener","doi":"10.1016/j.amjmed.2024.11.022","DOIUrl":"https://doi.org/10.1016/j.amjmed.2024.11.022","url":null,"abstract":"","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-05DOI: 10.1016/j.amjmed.2024.11.029
Shilpee Sinha, Shannon Countryman, Ami Patel, Chelsea Powell, James E Slaven, Amber R Comer, Alexia M Torke
Background: Goals of Care (GOC) documentation for seriously ill patients is integral to patient-centered care but not standardized. Collaborative efforts within the health system to improve the frequency and documentation of GOC to communicate patient preferences and values are essential to ensure both quality of life and quality of death.
Measures: We created a standard GOC note type and location in the electronic medical record (EMR) for a large, statewide health system in the Midwest. Utilization and note content for all unique GOC note types documented in the first year were reviewed. A framework of GOC topics including treatment plan, prognosis, patient preferences and values, and quality of life was used to review the note content. Demographic data and outcomes including death during the observation period and hospice enrollment were also collected.
Outcomes: In the first year, 934 GOC notes were documented. Palliative care (PC) clinicians addressed more GOC fields compared to other clinicians (70% v. 31%, p <.0001) and had earlier discussions (median 19 days before death v. 4 days, p<.0001). Hospice was discussed more by PC (50% vs 27%, p=.0001) and PC discussions were followed by higher hospice enrollments before death (50% vs 35% p=.0166).
Conclusions: We successfully implemented a standard EMR location for GOC notes which improved GOC documentation across a state health care system and found variations and gaps in fields addressed by all clinicians as well as key differences between PC clinicians vs other clinicians.
{"title":"Implementing Goals of Care Notes in a Statewide Health System: A Quality Improvement Initiative.","authors":"Shilpee Sinha, Shannon Countryman, Ami Patel, Chelsea Powell, James E Slaven, Amber R Comer, Alexia M Torke","doi":"10.1016/j.amjmed.2024.11.029","DOIUrl":"https://doi.org/10.1016/j.amjmed.2024.11.029","url":null,"abstract":"<p><strong>Background: </strong>Goals of Care (GOC) documentation for seriously ill patients is integral to patient-centered care but not standardized. Collaborative efforts within the health system to improve the frequency and documentation of GOC to communicate patient preferences and values are essential to ensure both quality of life and quality of death.</p><p><strong>Measures: </strong>We created a standard GOC note type and location in the electronic medical record (EMR) for a large, statewide health system in the Midwest. Utilization and note content for all unique GOC note types documented in the first year were reviewed. A framework of GOC topics including treatment plan, prognosis, patient preferences and values, and quality of life was used to review the note content. Demographic data and outcomes including death during the observation period and hospice enrollment were also collected.</p><p><strong>Outcomes: </strong>In the first year, 934 GOC notes were documented. Palliative care (PC) clinicians addressed more GOC fields compared to other clinicians (70% v. 31%, p <.0001) and had earlier discussions (median 19 days before death v. 4 days, p<.0001). Hospice was discussed more by PC (50% vs 27%, p=.0001) and PC discussions were followed by higher hospice enrollments before death (50% vs 35% p=.0166).</p><p><strong>Conclusions: </strong>We successfully implemented a standard EMR location for GOC notes which improved GOC documentation across a state health care system and found variations and gaps in fields addressed by all clinicians as well as key differences between PC clinicians vs other clinicians.</p>","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-03DOI: 10.1016/j.amjmed.2024.11.031
Luis Eduardo Mendoza-Razo, José Alberto Domínguez-López, Bryan Omar Díaz-Sánchez
{"title":"Unusually High Rhabdomyolysis-Induced Hyperkalemia.","authors":"Luis Eduardo Mendoza-Razo, José Alberto Domínguez-López, Bryan Omar Díaz-Sánchez","doi":"10.1016/j.amjmed.2024.11.031","DOIUrl":"https://doi.org/10.1016/j.amjmed.2024.11.031","url":null,"abstract":"","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-02DOI: 10.1016/j.amjmed.2024.11.019
Reynold Spector
Thirty percent of Americans report insomnia. After eliminating obvious causes, the best therapy for insomnia is cognitive behavioral therapy but this is not widely available. However, all the known oral sleeping aides are generally unsatisfactory. Recently, a new class of safe non-addicting, mechanism-based hypocretin blockers have been developed. Herein we review the information not only for insomnia but also for narcolepsy.
{"title":"Progress toward an Ideal Sleeping Pill.","authors":"Reynold Spector","doi":"10.1016/j.amjmed.2024.11.019","DOIUrl":"https://doi.org/10.1016/j.amjmed.2024.11.019","url":null,"abstract":"<p><p>Thirty percent of Americans report insomnia. After eliminating obvious causes, the best therapy for insomnia is cognitive behavioral therapy but this is not widely available. However, all the known oral sleeping aides are generally unsatisfactory. Recently, a new class of safe non-addicting, mechanism-based hypocretin blockers have been developed. Herein we review the information not only for insomnia but also for narcolepsy.</p>","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-02DOI: 10.1016/j.amjmed.2024.11.023
Edward J Goetzl
Recent applications of artificial intelligence-derived methods of computational design have permitted de novo creation of proteins that do not exist in nature but have potent effects on human cells and organ systems. These rapid procedures also allow in one step protein modifications that optimize function, potency, stability, resistance to biodegradation, cellular and tissue distribution and biological half-time. Such proteins generated to date include cytokines, antibodies, inhibitors of cell death proteins and antagonists of extracellular receptors for growth factors and viruses. Newly designed proteins have broad medical diagnostic and therapeutic potentials, as well as the capacity to alter many normal activities of human cells.
{"title":"Creating New Proteins for Medical Therapeutics: Short title: Designing Therapeutic Proteins.","authors":"Edward J Goetzl","doi":"10.1016/j.amjmed.2024.11.023","DOIUrl":"https://doi.org/10.1016/j.amjmed.2024.11.023","url":null,"abstract":"<p><p>Recent applications of artificial intelligence-derived methods of computational design have permitted de novo creation of proteins that do not exist in nature but have potent effects on human cells and organ systems. These rapid procedures also allow in one step protein modifications that optimize function, potency, stability, resistance to biodegradation, cellular and tissue distribution and biological half-time. Such proteins generated to date include cytokines, antibodies, inhibitors of cell death proteins and antagonists of extracellular receptors for growth factors and viruses. Newly designed proteins have broad medical diagnostic and therapeutic potentials, as well as the capacity to alter many normal activities of human cells.</p>","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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