Pub Date : 2025-02-11DOI: 10.1016/j.ajmo.2025.100088
Yasuhiro Kano
An 80-year-old man presented with a two-day history of anorexia and decreased daily activity. A physical examination revealed an erythematous, crusted, vesicular eruption distributed along the C3-C5 dermatome. Chest x-ray and computed tomography during inspiration and expiration demonstrated an elevation of the left hemidiaphragm with almost no movement of the left diaphragm during respiration. These findings were consistent with left diaphragmatic paralysis due to cervical herpes zoster. As a rare type of segmental motor paresis, cervical herpes zoster can cause phrenic nerve paralysis because the phrenic nerve originates in the anterior horn of the C3 to C5 roots. Diaphragmatic paralysis results in diminished vital capacity and can lead to a decline in exercise tolerance or daily activity, especially in elderly patients.
{"title":"Tracing the Rash: Diaphragmatic Paralysis Following Cervical Herpes Zoster","authors":"Yasuhiro Kano","doi":"10.1016/j.ajmo.2025.100088","DOIUrl":"10.1016/j.ajmo.2025.100088","url":null,"abstract":"<div><div>An 80-year-old man presented with a two-day history of anorexia and decreased daily activity. A physical examination revealed an erythematous, crusted, vesicular eruption distributed along the C3-C5 dermatome. Chest x-ray and computed tomography during inspiration and expiration demonstrated an elevation of the left hemidiaphragm with almost no movement of the left diaphragm during respiration. These findings were consistent with left diaphragmatic paralysis due to cervical herpes zoster. As a rare type of segmental motor paresis, cervical herpes zoster can cause phrenic nerve paralysis because the phrenic nerve originates in the anterior horn of the C3 to C5 roots. Diaphragmatic paralysis results in diminished vital capacity and can lead to a decline in exercise tolerance or daily activity, especially in elderly patients.</div></div>","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":"13 ","pages":"Article 100088"},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-03DOI: 10.1016/j.ajmo.2025.100091
Zein Kattih , Jonathan A Moore , Brandon Wilson , Sravani Gajjala , Jacob Schwartz , Josef Kushner , Sean Zajac , Akhilesh Mahajan , Tungming Leung , Priyanka Makkar
Background
Solitary pulmonary nodules (SPNs) are commonly identified on imaging studies, and guidelines exist for follow-up. Adherence to guideline recommendations varies.
Methods
We conducted a retrospective review at a single center in a metropolitan hospital to identify characteristics of patients with lung nodules and determine the rate of follow-up of these patients. A total of 1266 patient records were reviewed, and 341 patients with solitary pulmonary nodules were identified.
Results
The presence of emphysema was associated with an increased rate of follow-up with an odds ratio of 1.9. Of the patients with SPNs, 52% do not receive appropriate follow-up. Of the nodules identified, 40% were noted to be enlarged compared to prior imaging.
Conclusions
Identification of SPNs requires a standard approach to ensure follow-up for early detection of potential malignancy. Appropriate follow-up allows improvement of the rate of early cancer detection.
{"title":"Rate of Incidental Lung Nodule Follow-Up: A Cohort Study Evaluating Adherence to Guideline Recommendations","authors":"Zein Kattih , Jonathan A Moore , Brandon Wilson , Sravani Gajjala , Jacob Schwartz , Josef Kushner , Sean Zajac , Akhilesh Mahajan , Tungming Leung , Priyanka Makkar","doi":"10.1016/j.ajmo.2025.100091","DOIUrl":"10.1016/j.ajmo.2025.100091","url":null,"abstract":"<div><h3>Background</h3><div>Solitary pulmonary nodules (SPNs) are commonly identified on imaging studies, and guidelines exist for follow-up. Adherence to guideline recommendations varies.</div></div><div><h3>Methods</h3><div>We conducted a retrospective review at a single center in a metropolitan hospital to identify characteristics of patients with lung nodules and determine the rate of follow-up of these patients. A total of 1266 patient records were reviewed, and 341 patients with solitary pulmonary nodules were identified.</div></div><div><h3>Results</h3><div>The presence of emphysema was associated with an increased rate of follow-up with an odds ratio of 1.9. Of the patients with SPNs, 52% do not receive appropriate follow-up. Of the nodules identified, 40% were noted to be enlarged compared to prior imaging.</div></div><div><h3>Conclusions</h3><div>Identification of SPNs requires a standard approach to ensure follow-up for early detection of potential malignancy. Appropriate follow-up allows improvement of the rate of early cancer detection.</div></div>","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":"13 ","pages":"Article 100091"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143821423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.ajmo.2024.100085
Nikitha Garapaty , Kristina M. Reyes , Lily Tehrani , Maximiliano Barbosa Mendoza , Patrick Hardigan
The symptomology of Myalgic Encephalitis/Chronic Fatigue Syndrome (ME/CFS) shares many commonalities with Long COVID (LC). This study aimed to clearly define the comparison between ME/CFS and LC in terms of symptomology. A cross-sectional analysis of 27,651 interviewees from a National Health Interview Survey 2022 adult dataset was conducted. The data was controlled for subject's sex, race/ethnicity, age, life satisfaction, insurance coverage, poverty ratio, and comorbidities. A logistic regression was used to compare four groups: (1) LC individuals, (2) ME/CFS individuals, (3) LC with ME/CFS individuals, and (4) controls by symptoms of depression, anxiety, physical activity, fatigue, and memory. The results showed that subjects with both ME/CFS and LC were more likely to report memory issues, anxiety, depression, fatigue, and difficulty with physical activity followed by subjects with ME/CFS only, LC only, and the controls (P < .01). Our study suggests a synergistic mechanism between ME/CFS and LC in developing issues with anxiety, depression, fatigue, and physically activity in patients. The study's conclusions highlight the need to elucidate the possible overlap in pathophysiological mechanisms of ME/CFS and LC in the symptomology of patients.
{"title":"Assessing the Relationship in Symptomology of Myalgic Encephalitis/Chronic Fatigue Syndrome and Long COVID","authors":"Nikitha Garapaty , Kristina M. Reyes , Lily Tehrani , Maximiliano Barbosa Mendoza , Patrick Hardigan","doi":"10.1016/j.ajmo.2024.100085","DOIUrl":"10.1016/j.ajmo.2024.100085","url":null,"abstract":"<div><div>The symptomology of Myalgic Encephalitis/Chronic Fatigue Syndrome (ME/CFS) shares many commonalities with Long COVID (LC). This study aimed to clearly define the comparison between ME/CFS and LC in terms of symptomology. A cross-sectional analysis of 27,651 interviewees from a National Health Interview Survey 2022 adult dataset was conducted. The data was controlled for subject's sex, race/ethnicity, age, life satisfaction, insurance coverage, poverty ratio, and comorbidities. A logistic regression was used to compare four groups: (1) LC individuals, (2) ME/CFS individuals, (3) LC with ME/CFS individuals, and (4) controls by symptoms of depression, anxiety, physical activity, fatigue, and memory. The results showed that subjects with both ME/CFS and LC were more likely to report memory issues, anxiety, depression, fatigue, and difficulty with physical activity followed by subjects with ME/CFS only, LC only, and the controls (<em>P</em> < .01). Our study suggests a synergistic mechanism between ME/CFS and LC in developing issues with anxiety, depression, fatigue, and physically activity in patients. The study's conclusions highlight the need to elucidate the possible overlap in pathophysiological mechanisms of ME/CFS and LC in the symptomology of patients.</div></div>","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":"13 ","pages":"Article 100085"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143823525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.ajmo.2025.100090
Rawan El Kurdi , Krish H. Nayar , Michael B. Gotway , Janis Blair , Sandhya Nagarakanti
Cavitary pneumonia, characterized by gas-filled spaces within lung tissue, is commonly associated with bacterial pathogens, such as Staphylococcus aureus, Streptococcus, Pseudomonas, and Klebsiella species. This study aimed to investigate the most common causes of cavitary pneumonia in southern Arizona, where coccidioidomycosis is endemic. Fungal infections were the predominant cause of cavitary pneumonia (69%), either alone or in association with bacterial infections. Seven percent of patients had concurrent fungal and bacterial infections. Overall, coccidioidomycosis was the most common cause of cavitary pneumonia, accounting for 39% of all cases and 82% of fungal cases. Among these, 24% had proven coccidioidomycosis, 51% had probable infections, and 25% had possible infections. Bacterial infections accounted for 30% of cavitary pneumonia cases, with Staphylococcus aureus (12%), Streptococcus species (12%), and Pseudomonas species (11%) being the most prevalent organisms. Overall mortality was 25%, with 34% of deaths directly attributed to cavitary pneumonia.
{"title":"Cavitary Pneumonia Causes in the Arid Landscapes of Southern Arizona","authors":"Rawan El Kurdi , Krish H. Nayar , Michael B. Gotway , Janis Blair , Sandhya Nagarakanti","doi":"10.1016/j.ajmo.2025.100090","DOIUrl":"10.1016/j.ajmo.2025.100090","url":null,"abstract":"<div><div>Cavitary pneumonia, characterized by gas-filled spaces within lung tissue, is commonly associated with bacterial pathogens, such as <em>Staphylococcus aureus, Streptococcus, Pseudomonas</em>, and <em>Klebsiella</em> species. This study aimed to investigate the most common causes of cavitary pneumonia in southern Arizona, where coccidioidomycosis is endemic. Fungal infections were the predominant cause of cavitary pneumonia (69%), either alone or in association with bacterial infections. Seven percent of patients had concurrent fungal and bacterial infections. Overall, coccidioidomycosis was the most common cause of cavitary pneumonia, accounting for 39% of all cases and 82% of fungal cases. Among these, 24% had proven coccidioidomycosis, 51% had probable infections, and 25% had possible infections. Bacterial infections accounted for 30% of cavitary pneumonia cases, with <em>Staphylococcus aureus</em> (12%), <em>Streptococcus</em> species (12%), and <em>Pseudomonas</em> species (11%) being the most prevalent organisms. Overall mortality was 25%, with 34% of deaths directly attributed to cavitary pneumonia.</div></div>","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":"13 ","pages":"Article 100090"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143445588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-30DOI: 10.1016/j.ajmo.2025.100089
Aamir Javaid , Essa Hariri , Bige Ozkan , Katherine Lang , Sadiya S. Khan , Janani Rangaswami , Neil J. Stone , Roger S. Blumenthal , Chiadi E. Ndumele
These 4 hypothetical cases highlight new features of the American Heart Association cardiovascular-kidney-metabolic (CKM) health construct. The cases incorporate the CKM staging system, estimates from the PREVENT risk calculator, and clinical approaches related to CKM stages and individual risk profiles. Topics include management considerations for (1) a patient with stage 1 obesity and impaired glucose tolerance, (2) a patient with metabolic risk factors and moderate-risk chronic kidney disease (CKD), (3) a patient with subclinical atherosclerotic cardiovascular disease and multiple comorbid conditions, and (4) a patient with metabolic risk factors, prior myocardial infarction, new-onset heart failure, atrial fibrillation, and CKD.
{"title":"Cardiovascular-Kidney-Metabolic (CKM) Syndrome: A Case-Based Narrative Review","authors":"Aamir Javaid , Essa Hariri , Bige Ozkan , Katherine Lang , Sadiya S. Khan , Janani Rangaswami , Neil J. Stone , Roger S. Blumenthal , Chiadi E. Ndumele","doi":"10.1016/j.ajmo.2025.100089","DOIUrl":"10.1016/j.ajmo.2025.100089","url":null,"abstract":"<div><div>These 4 hypothetical cases highlight new features of the American Heart Association cardiovascular-kidney-metabolic (CKM) health construct. The cases incorporate the CKM staging system, estimates from the PREVENT risk calculator, and clinical approaches related to CKM stages and individual risk profiles. Topics include management considerations for (1) a patient with stage 1 obesity and impaired glucose tolerance, (2) a patient with metabolic risk factors and moderate-risk chronic kidney disease (CKD), (3) a patient with subclinical atherosclerotic cardiovascular disease and multiple comorbid conditions, and (4) a patient with metabolic risk factors, prior myocardial infarction, new-onset heart failure, atrial fibrillation, and CKD.</div></div>","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":"13 ","pages":"Article 100089"},"PeriodicalIF":0.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143512056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-14DOI: 10.1016/j.ajmo.2025.100087
Ian Beeton , Jay Acharya , Bengisu Kesin Meric , James Hobden , Tahir Ali , Thang S. Han
Background
There is a paucity of data on direct comparison of clinical measures in patients with abdominal aortic aneurysm (AAA) and those with peripheral arterial disease (PAD). Here, we examine the risk factors and outcomes between these 2 conditions.
Methods
Group differences were examined by Fisher's exact tests with Bonferroni correction, postoperative complications (including delirium and pneumonia) and LOS by logistic regression, and mortality by Cox regression, adjusted for age, sex, smoking, co-morbidities and medications.
Results
In total, 160 men and 33 women aged 74.5years (SD = 9.4) were referred for preoperative cardiac assessment for AAA (n = 70) and PAD (n = 123). Vascular surgery was performed in 148 patients (70% of AAA; 80.5% of PAD). Myocardial infarct was more prevalent in AAA, and diabetes more in PAD, whilst atrial fibrillation, stroke, congestive heart failure and hypertension did not differ between groups. Compared to patients with PAD, there were higher proportions of patients with AAA prescribed with cardiovascular medications, and developed post-operative complications in hospital: odds ratio = 7.34 (95% CI, 2.26-23.84, P < .001), and stayed in hospital >1week: odds ratio = 2.60 (95% CI, 1.15-5.85, P = .021). Compared to those with AAA, patients with PAD were at greater risk of death in the entire sample: hazard ratio = 3.34 (95% CI, 1.64-6.79), and in those who underwent vascular surgery: hazard ratio = 4.90 (95% CI, 1.88-12.79). Left ventricular function did not relate to outcomes.
Conclusions
Differences between AAA and PAD in risk profile and management which may have a bearing on higher risk of death associated with PAD. More intensive cardiovascular management may help improve their outcomes.
{"title":"Comparisons of risk factors and outcomes between abdominal aortic aneurysm and peripheral arterial disease: a case-control study","authors":"Ian Beeton , Jay Acharya , Bengisu Kesin Meric , James Hobden , Tahir Ali , Thang S. Han","doi":"10.1016/j.ajmo.2025.100087","DOIUrl":"10.1016/j.ajmo.2025.100087","url":null,"abstract":"<div><h3>Background</h3><div>There is a paucity of data on direct comparison of clinical measures in patients with abdominal aortic aneurysm (AAA) and those with peripheral arterial disease (PAD). Here, we examine the risk factors and outcomes between these 2 conditions.</div></div><div><h3>Methods</h3><div>Group differences were examined by Fisher's exact tests with Bonferroni correction, postoperative complications (including delirium and pneumonia) and LOS by logistic regression, and mortality by Cox regression, adjusted for age, sex, smoking, co-morbidities and medications.</div></div><div><h3>Results</h3><div>In total, 160 men and 33 women aged 74.5years (SD = 9.4) were referred for preoperative cardiac assessment for AAA (<em>n</em> = 70) and PAD (<em>n</em> = 123). Vascular surgery was performed in 148 patients (70% of AAA; 80.5% of PAD). Myocardial infarct was more prevalent in AAA, and diabetes more in PAD, whilst atrial fibrillation, stroke, congestive heart failure and hypertension did not differ between groups. Compared to patients with PAD, there were higher proportions of patients with AAA prescribed with cardiovascular medications, and developed post-operative complications in hospital: odds ratio = 7.34 (95% CI, 2.26-23.84, <em>P</em> < .001), and stayed in hospital >1week: odds ratio = 2.60 (95% CI, 1.15-5.85, <em>P</em> = .021). Compared to those with AAA, patients with PAD were at greater risk of death in the entire sample: hazard ratio = 3.34 (95% CI, 1.64-6.79), and in those who underwent vascular surgery: hazard ratio = 4.90 (95% CI, 1.88-12.79). Left ventricular function did not relate to outcomes.</div></div><div><h3>Conclusions</h3><div>Differences between AAA and PAD in risk profile and management which may have a bearing on higher risk of death associated with PAD. More intensive cardiovascular management may help improve their outcomes.</div></div>","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":"13 ","pages":"Article 100087"},"PeriodicalIF":0.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143132933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Malnutrition is related to increased mortality and poor outcome. Therefore, early diagnosis and intervention of malnutrition are recommended. However, the optimal nutrition screening tool for diagnosing malnutrition remains undetermined. This study aimed to verify the discrimination and difficulty of nutrition screening items through item response theory (IRT) analysis and develop a simpler malnutrition screening tool.
Methods
This study enrolled 10,375 patients aged ≥18 years who were admitted at Tokushima University Hospital. Patients who were pregnant had short-term hospitalization (≤3 days), were hospitalized only in the weekend, could not hear clearly, and were hospitalized merely for examination were excluded. A skilled dietitian performed the Subjective Global Assessment, rating a good nutritional status as A, moderate malnutrition as B, and severe malnutrition as C.
Results
According to Subjective Global Assessment, we classified 7119 patients as A, 2892 as B, and 364 as C. Between these classes, the total number of application items was significantly lower in class A but significantly higher in class C. In the discrimination of each item calculated by IRT analysis, the highest discrimination item was “Has your food intake been less than usual?”, followed by “Have you had anorexia?”, “Have you had vomiting?”, “Have you had nausea?”, “Have you had dehydration?”, and “Have you lost weight?”.
Conclusions
Human Key Tool of Nutrition, which is based on the IRT analysis results, is a new simple nutrition screening tool developed by us. Human Key Tool of Nutrition can contribute to the widespread use of nutrition screening.
{"title":"Development of a New Malnutrition Screening Tool for Patients: Human Key Tool of Nutrition","authors":"Kotono Oishi MSc, Arisa Inoue-Hamano PhD, Yasuhiro Hamada MD,PhD","doi":"10.1016/j.ajmo.2024.100086","DOIUrl":"10.1016/j.ajmo.2024.100086","url":null,"abstract":"<div><h3>Background and aims</h3><div>Malnutrition is related to increased mortality and poor outcome. Therefore, early diagnosis and intervention of malnutrition are recommended. However, the optimal nutrition screening tool for diagnosing malnutrition remains undetermined. This study aimed to verify the discrimination and difficulty of nutrition screening items through item response theory (IRT) analysis and develop a simpler malnutrition screening tool.</div></div><div><h3>Methods</h3><div>This study enrolled 10,375 patients aged ≥18 years who were admitted at Tokushima University Hospital. Patients who were pregnant had short-term hospitalization (≤3 days), were hospitalized only in the weekend, could not hear clearly, and were hospitalized merely for examination were excluded. A skilled dietitian performed the Subjective Global Assessment, rating a good nutritional status as A, moderate malnutrition as B, and severe malnutrition as C.</div></div><div><h3>Results</h3><div>According to Subjective Global Assessment, we classified 7119 patients as A, 2892 as B, and 364 as C. Between these classes, the total number of application items was significantly lower in class A but significantly higher in class C. In the discrimination of each item calculated by IRT analysis, the highest discrimination item was “Has your food intake been less than usual?”, followed by “Have you had anorexia?”, “Have you had vomiting?”, “Have you had nausea?”, “Have you had dehydration?”, and “Have you lost weight?”.</div></div><div><h3>Conclusions</h3><div>Human Key Tool of Nutrition, which is based on the IRT analysis results, is a new simple nutrition screening tool developed by us. Human Key Tool of Nutrition can contribute to the widespread use of nutrition screening.</div></div>","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":"13 ","pages":"Article 100086"},"PeriodicalIF":0.0,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143132902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-17DOI: 10.1016/j.ajmo.2024.100084
Andrew W. Gardner , Polly S. Montgomery , Ming Wang , Menglu Liang , Shangming Zhang , William A. Pomilla , Neyha Cherin
Purpose
We compared the prevalence of older cardiovascular patients with and without metabolic syndrome (MetS) who met the recommendations of walking more than 7000 and 10,000 steps/d, and we determined whether MetS status was significantly associated with meeting the daily step count recommendations before and after adjusting for demographic variables, comorbid conditions, and cardiovascular risk factors.
Methods
Older cardiovascular participants with MetS (n = 489) and without MetS (n = 154) were assessed on their walking for seven consecutive days with a StepWatch activity monitor.
Results
The MetS group took significantly fewer steps/d than the non-MetS control group (7307 ± 3625 vs. 8933 ± 4487 steps/d; P < .001). Only 47 % and 21 % of the MetS group walked ≥7000 and 10,000 steps/d, respectively, whereas 68 % and 34 % of the control group met these recommendations (P < .001 and p = .002, respectively). The odds of walking 7000 steps/d were 52 % lower in the MetS group (OR = 0.48, 95 %CI = 0.29-0.77, P = .003), and the odds of walking 10,000 steps/d were a 37 % lower trend (OR = 0.63, 95 %CI = 0.39-1.04, P = .069). Additionally, the odds of walking 7000 and 10,000 steps/d were lower in participants with reduced HDL-cholesterol (OR = 0.35, 95 %CI = 0.21-0.60, P < .001 and OR = 0.45, 95 %CI = 0.25-0.80, P = .007, respectively) and abdominal obesity (OR = 0.52, 95 %CI = 0.37-0.74, P < .001 and OR = 0.45, 95 %CI = 0.30-0.68, P < .001, respectively).
Conclusions
Older cardiovascular participants with MetS had an 18 % lower daily step count compared to those without MetS and were less likely to meet the 7000 and 10,000 steps/d recommendations. Additionally, older cardiovascular participants who were least likely to meet the daily step count recommendations included those who had reduced HDL-cholesterol and abdominal obesity.
目的：我们比较了有代谢综合征（MetS）和无代谢综合征（MetS）的老年心血管患者的患病率，这些患者每天步行超过7000步和10000步/天，我们确定在调整人口统计学变量、合并症和心血管危险因素之前和之后，MetS状态是否与满足每日步数建议显著相关。方法使用StepWatch活动监测仪连续7天评估患有MetS的心血管参与者（n = 489）和没有MetS的参与者（n = 154）的步行情况。结果met组步行步数明显少于非met组（7307±3625 vs 8933±4487）；P & lt;措施)。met组中分别只有47 %和21 %的人每天步行≥7000步和10000步，而对照组中分别有68 %和34 %的人达到了这些建议(P <；.001和p = .002)。MetS组步行7000步/天的几率降低了52% % (OR = 0.48, 95 %CI = 0.29-0.77, P = 0.003)，步行10,000步/天的几率降低了37% % （OR = 0.63, 95 %CI = 0.39-1.04, P = 0.069）。此外，高密度脂蛋白胆固醇降低的参与者每天步行7000步和10000步的几率更低(OR = 0.35, 95 %CI = 0.21-0.60, P <；.001, OR = 0.45, 95 %CI = 0.25-0.80, P = 0.007)和腹部肥胖(OR = 0.52, 95 %CI = 0.37-0.74, P <；.001, OR = 0.45, 95 %CI = 0.30-0.68, P <；措施,分别)。结论：与没有MetS的参与者相比，患有MetS的心血管参与者的每日步数降低了18. %，并且不太可能达到建议的7000步和10,000步/天。此外，最不可能达到每日步数建议的老年心血管参与者包括那些高密度脂蛋白胆固醇降低和腹部肥胖的人。
{"title":"Prevalence of Meeting Daily Step Count Recommendations in Cardiovascular Patients With and Without Metabolic Syndrome","authors":"Andrew W. Gardner , Polly S. Montgomery , Ming Wang , Menglu Liang , Shangming Zhang , William A. Pomilla , Neyha Cherin","doi":"10.1016/j.ajmo.2024.100084","DOIUrl":"10.1016/j.ajmo.2024.100084","url":null,"abstract":"<div><h3>Purpose</h3><div>We compared the prevalence of older cardiovascular patients with and without metabolic syndrome (MetS) who met the recommendations of walking more than 7000 and 10,000 steps/d, and we determined whether MetS status was significantly associated with meeting the daily step count recommendations before and after adjusting for demographic variables, comorbid conditions, and cardiovascular risk factors.</div></div><div><h3>Methods</h3><div>Older cardiovascular participants with MetS (<em>n</em> = 489) and without MetS (<em>n</em> = 154) were assessed on their walking for seven consecutive days with a StepWatch activity monitor.</div></div><div><h3>Results</h3><div>The MetS group took significantly fewer steps/d than the non-MetS control group (7307 ± 3625 vs. 8933 ± 4487 steps/d; <em>P</em> < .001). Only 47 % and 21 % of the MetS group walked ≥7000 and 10,000 steps/d, respectively, whereas 68 % and 34 % of the control group met these recommendations (<em>P</em> < .001 and <em>p</em> = .002, respectively). The odds of walking 7000 steps/d were 52 % lower in the MetS group (OR = 0.48, 95 %CI = 0.29-0.77, <em>P =</em> .003), and the odds of walking 10,000 steps/d were a 37 % lower trend (OR = 0.63, 95 %CI = 0.39-1.04, <em>P</em> = .069). Additionally, the odds of walking 7000 and 10,000 steps/d were lower in participants with reduced HDL-cholesterol (OR = 0.35, 95 %CI = 0.21-0.60, <em>P</em> < .001 and OR = 0.45, 95 %CI = 0.25-0.80, <em>P</em> = .007, respectively) and abdominal obesity (OR = 0.52, 95 %CI = 0.37-0.74, <em>P</em> < .001 and OR = 0.45, 95 %CI = 0.30-0.68, <em>P</em> < .001, respectively).</div></div><div><h3>Conclusions</h3><div>Older cardiovascular participants with MetS had an 18 % lower daily step count compared to those without MetS and were less likely to meet the 7000 and 10,000 steps/d recommendations. Additionally, older cardiovascular participants who were least likely to meet the daily step count recommendations included those who had reduced HDL-cholesterol and abdominal obesity.</div></div>","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":"13 ","pages":"Article 100084"},"PeriodicalIF":0.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-07DOI: 10.1016/j.ajmo.2024.100081
Leonardo Pozo Garcia , Livia Frost , Bryan M. Tucker
Pseudohyponatremia is frequently misunderstood and often mistaken for other types of hyponatremia. In this study, we present a case of pseudohyponatremia resulting from hypertriglyceridemia. We provide an in-depth analysis of the pathophysiological mechanisms involved, comparing them with those of other hyponatremic disorders, and outline the diagnostic approach used to identify this atypical form of hyponatremia. Recognizing and accurately diagnosing non–hypo-osmolar hyponatremia is paramount, as these conditions are treated differently than other forms of hyponatremia.
{"title":"Hyponatremia with an Osmolar Gap, Pseudohyponatremia or Hyper-Osmolar Hyponatremia?","authors":"Leonardo Pozo Garcia , Livia Frost , Bryan M. Tucker","doi":"10.1016/j.ajmo.2024.100081","DOIUrl":"10.1016/j.ajmo.2024.100081","url":null,"abstract":"<div><div>Pseudohyponatremia is frequently misunderstood and often mistaken for other types of hyponatremia. In this study, we present a case of pseudohyponatremia resulting from hypertriglyceridemia. We provide an in-depth analysis of the pathophysiological mechanisms involved, comparing them with those of other hyponatremic disorders, and outline the diagnostic approach used to identify this atypical form of hyponatremia. Recognizing and accurately diagnosing non–hypo-osmolar hyponatremia is paramount, as these conditions are treated differently than other forms of hyponatremia.</div></div>","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":"13 ","pages":"Article 100081"},"PeriodicalIF":0.0,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11743811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.ajmo.2023.100061
Daniel M. Gelfman MD
This commentary discusses a new, previously unrecognized, undocumented, anatomic finding concerning the jugular venous distention present on one of the world’s most famous statues, Michelangelo’s David. This finding is provocative as it involves of one of Michelangelo’s “messages” being demonstrated in The David, has clinical relevance, and, appears to reveal something about Michelangelo, himself.
{"title":"The David Sign, Revisited","authors":"Daniel M. Gelfman MD","doi":"10.1016/j.ajmo.2023.100061","DOIUrl":"10.1016/j.ajmo.2023.100061","url":null,"abstract":"<div><div>This commentary discusses a new, previously unrecognized, undocumented, anatomic finding concerning the jugular venous distention present on one of the world’s most famous statues, Michelangelo’s David. This finding is provocative as it involves of one of Michelangelo’s “messages” being demonstrated in The David, has clinical relevance, and, appears to reveal something about Michelangelo, himself.</div></div>","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":"12 ","pages":"Article 100061"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136152418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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