Pub Date : 2026-01-24DOI: 10.1016/j.amjmed.2026.01.027
William H Frishman, Wilbert S Aronow, Joseph Alpert
{"title":"Beta-Adrenergic Blockade in Survivors of Acute Myocardial Infarction: A half-century of Clinical rails and Therapeutic Recommendations.","authors":"William H Frishman, Wilbert S Aronow, Joseph Alpert","doi":"10.1016/j.amjmed.2026.01.027","DOIUrl":"https://doi.org/10.1016/j.amjmed.2026.01.027","url":null,"abstract":"","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146054765","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 : 2026-01-24DOI: 10.1016/j.amjmed.2026.01.036
Teresa Sevilla, Jose Francisco Gil-Fernandez, Guillermo Pereña-Rodriguez, Ana Revilla-Orodea, Esther González-Bartol, Manuel Carrasco-Moraleja, Sofía Campillo de Blas, María Jesús Rollán, Iside Vilacosta, J Alberto San Román
Background: Heart failure is a frequent manifestation in patients with severe aortic stenosis (AS), yet its timing in relation to aortic valve replacement (AVR) and its prognostic implications remain underexplored. We aimed to assess the clinical characteristics and outcomes of patients who developed heart failure before or after isolated AVR and identify those at highest risk.
Methods: We conducted a retrospective observational study of 451 consecutive patients with isolated, symptomatic, severe AS who underwent surgical or transcatheter AVR at two centers between 2013 and 2017. Patients with other significant valvular lesions or coronary artery disease were excluded. Heart failure was defined as hospitalization for congestive symptoms. Median follow-up was 56 months. All-cause mortality and heart failure rehospitalization were recorded.
Results: Heart failure occurred in 133 patients (29.5%) prior to AVR and in 60 patients (13.3%) during follow-up. Patients with heart failure-either before or after AVR-were older, predominantly female, and showed signs of more advanced extravalvular cardiac damage. Persistent heart failure (heart failure both before and after AVR) was observed in 30 patients and was associated with the worst prognosis: 76.7% all-cause mortality during follow-up vs 19.1% in patients who never experienced heart failure, p<0.001. Predictors of post-AVR heart failure included age, female sex, baseline atrial fibrillation, prior heart failure, and higher body mass index.
Conclusions: Heart failure, whether occurring before or after AVR, is common and linked to poor outcomes. Persistent heart failure identifies a particularly high-risk subgroup. Heart failure in severe AS reflects not only valvular obstruction but also widespread cardiac dysfunction and patient-specific vulnerability.
{"title":"Prognostic Implications of Pre- and Post-Procedural Heart Failure in Patients Undergoing Aortic Valve Replacement.","authors":"Teresa Sevilla, Jose Francisco Gil-Fernandez, Guillermo Pereña-Rodriguez, Ana Revilla-Orodea, Esther González-Bartol, Manuel Carrasco-Moraleja, Sofía Campillo de Blas, María Jesús Rollán, Iside Vilacosta, J Alberto San Román","doi":"10.1016/j.amjmed.2026.01.036","DOIUrl":"https://doi.org/10.1016/j.amjmed.2026.01.036","url":null,"abstract":"<p><strong>Background: </strong>Heart failure is a frequent manifestation in patients with severe aortic stenosis (AS), yet its timing in relation to aortic valve replacement (AVR) and its prognostic implications remain underexplored. We aimed to assess the clinical characteristics and outcomes of patients who developed heart failure before or after isolated AVR and identify those at highest risk.</p><p><strong>Methods: </strong>We conducted a retrospective observational study of 451 consecutive patients with isolated, symptomatic, severe AS who underwent surgical or transcatheter AVR at two centers between 2013 and 2017. Patients with other significant valvular lesions or coronary artery disease were excluded. Heart failure was defined as hospitalization for congestive symptoms. Median follow-up was 56 months. All-cause mortality and heart failure rehospitalization were recorded.</p><p><strong>Results: </strong>Heart failure occurred in 133 patients (29.5%) prior to AVR and in 60 patients (13.3%) during follow-up. Patients with heart failure-either before or after AVR-were older, predominantly female, and showed signs of more advanced extravalvular cardiac damage. Persistent heart failure (heart failure both before and after AVR) was observed in 30 patients and was associated with the worst prognosis: 76.7% all-cause mortality during follow-up vs 19.1% in patients who never experienced heart failure, p<0.001. Predictors of post-AVR heart failure included age, female sex, baseline atrial fibrillation, prior heart failure, and higher body mass index.</p><p><strong>Conclusions: </strong>Heart failure, whether occurring before or after AVR, is common and linked to poor outcomes. Persistent heart failure identifies a particularly high-risk subgroup. Heart failure in severe AS reflects not only valvular obstruction but also widespread cardiac dysfunction and patient-specific vulnerability.</p>","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146054844","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 : 2026-01-23DOI: 10.1016/j.amjmed.2026.01.021
Feyza Achilova, Mohammad Daher, Joseph E Nassar, Alan H Daniels, Joseph A Abboud
Adhesive capsulitis, commonly referred to as frozen shoulder, is a frequent cause of shoulder pain and stiffness in middle-aged adults and is associated with substantial functional limitation. Although traditionally considered a self-limited condition, growing evidence suggests that many patients experience prolonged symptoms and incomplete recovery. Diagnosis is primarily clinical, based on characteristic history and examination findings demonstrating global restriction of passive glenohumeral motion, with imaging reserved for exclusion of alternative pathology. Management is predominantly nonoperative and should be individualized according to disease stage, symptom severity, and patient comorbidities. Corticosteroid injection and physical therapy provide meaningful benefit in appropriately selected patients, while surgical intervention is reserved for refractory cases. This review summarizes the current understanding of the epidemiology, clinical presentation, diagnostic approach, and evidence-based management of adhesive capsulitis, emphasizing practical considerations to guide patient-centered care.
{"title":"Frozen Shoulder: Diagnosis and Treatment of Adhesive Capsulitis.","authors":"Feyza Achilova, Mohammad Daher, Joseph E Nassar, Alan H Daniels, Joseph A Abboud","doi":"10.1016/j.amjmed.2026.01.021","DOIUrl":"https://doi.org/10.1016/j.amjmed.2026.01.021","url":null,"abstract":"<p><p>Adhesive capsulitis, commonly referred to as frozen shoulder, is a frequent cause of shoulder pain and stiffness in middle-aged adults and is associated with substantial functional limitation. Although traditionally considered a self-limited condition, growing evidence suggests that many patients experience prolonged symptoms and incomplete recovery. Diagnosis is primarily clinical, based on characteristic history and examination findings demonstrating global restriction of passive glenohumeral motion, with imaging reserved for exclusion of alternative pathology. Management is predominantly nonoperative and should be individualized according to disease stage, symptom severity, and patient comorbidities. Corticosteroid injection and physical therapy provide meaningful benefit in appropriately selected patients, while surgical intervention is reserved for refractory cases. This review summarizes the current understanding of the epidemiology, clinical presentation, diagnostic approach, and evidence-based management of adhesive capsulitis, emphasizing practical considerations to guide patient-centered care.</p>","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047160","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 : 2026-01-23DOI: 10.1016/j.amjmed.2026.01.034
Eri Onozawa, Masaki Itagane
{"title":"A Man with Marked Cytopenias and Low C-Reactive Protein: Severe Fever with Thrombocytopenia Syndrome.","authors":"Eri Onozawa, Masaki Itagane","doi":"10.1016/j.amjmed.2026.01.034","DOIUrl":"https://doi.org/10.1016/j.amjmed.2026.01.034","url":null,"abstract":"","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047134","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 : 2026-01-22DOI: 10.1016/j.amjmed.2025.09.030
Bryan D. Kraft MD, Sweta M. Patel MD, MSc
{"title":"The Reply","authors":"Bryan D. Kraft MD, Sweta M. Patel MD, MSc","doi":"10.1016/j.amjmed.2025.09.030","DOIUrl":"10.1016/j.amjmed.2025.09.030","url":null,"abstract":"","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":"139 2","pages":"Page e62"},"PeriodicalIF":5.3,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146006767","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}
{"title":"Commercial Sponsorship and Methodological Quality in Collagen Supplementation Trials: A Call for Independent Evidence in Dermatologic Research","authors":"Cintia Itzayana Muñoz-Santiago BSc , Agustin Lugo-Radillo MD, PhD","doi":"10.1016/j.amjmed.2025.05.045","DOIUrl":"10.1016/j.amjmed.2025.05.045","url":null,"abstract":"","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":"139 2","pages":"Page e73"},"PeriodicalIF":5.3,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146006805","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 : 2026-01-22DOI: 10.1016/j.amjmed.2025.09.017
Liying Zhai MD, Da Teng MD
{"title":"Beyond one-size-fits-all: The future of beta-blockers in coronary artery disease","authors":"Liying Zhai MD, Da Teng MD","doi":"10.1016/j.amjmed.2025.09.017","DOIUrl":"10.1016/j.amjmed.2025.09.017","url":null,"abstract":"","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":"139 2","pages":"Pages e57-e58"},"PeriodicalIF":5.3,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146006764","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 : 2026-01-22DOI: 10.1016/j.amjmed.2025.08.017
Hasan Tahsin Gozdas MD
{"title":"Management of opportunistic pneumonia in an HIV/AIDS patient","authors":"Hasan Tahsin Gozdas MD","doi":"10.1016/j.amjmed.2025.08.017","DOIUrl":"10.1016/j.amjmed.2025.08.017","url":null,"abstract":"","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":"139 2","pages":"Page e61"},"PeriodicalIF":5.3,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146006766","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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