Am J Med Sci
· 2026 Mar · PMID 41297763
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The life of Alexis Carrel, recipient of the 1912 Nobel Prize in Physiology or Medicine, is closely linked to Lourdes and the religious tensions that marked twentieth-century France. In 1902, he traveled to Lourdes. Upon...The life of Alexis Carrel, recipient of the 1912 Nobel Prize in Physiology or Medicine, is closely linked to Lourdes and the religious tensions that marked twentieth-century France. In 1902, he traveled to Lourdes. Upon his return, his account of the cure of Marie Bailly-a twenty-three-year-old woman suffering from peritonitis according to several physicians-caused a scandal in French academic circles. His Chief of Surgery subsequently dismissed him. In 1904, he went into exile in Canada, then the United States, where he established connections with Charles Claude Guthrie, Hervey Cushing and Simon Flexner, who welcomed him to the Rockefeller Institute. Over the years, Carrel lost all contact with Marie Bailly. Decades later, in the 1930s and again in the 1960s, attempts to reopen her medical records met with limited success. Was it a case of tubercular peritonitis or pseudoperitonitis? A misinterpretation-or an exceptional recovery? This article reexamines the case of Marie Bailly based on unpublished documents from the Sanctuary of Lourdes Archives, including Carrel's original notes.
Al-U'datt D, Mahmoud D, Tranchant CC
… +4 more, Rawashdeh S, Tashtush A, Almoghrabi KS, Alfwaress MF
Am J Med Sci
· 2026 Apr · PMID 41297762
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BACKGROUND AND AIMS: Type 2 diabetes mellitus (DM) is a modifiable risk factor for atrial fibrillation (AF). Some fibrotic and inflammatory markers associated with DM may contribute to structural fibrosis and electrical...BACKGROUND AND AIMS: Type 2 diabetes mellitus (DM) is a modifiable risk factor for atrial fibrillation (AF). Some fibrotic and inflammatory markers associated with DM may contribute to structural fibrosis and electrical remodeling in AF. This cross-sectional study aimed to assess the pathophysiological interrelationships between DM and AF by comparing diverse circulating and cardiac structural markers in patients diagnosed with either condition or both. METHODS AND RESULTS: Data were collected retrospectively from the medical records of 647 eligible adults: DM group (n = 192, mean age 55 years), AF group (n = 160, 61.8 years), AF+DM group (n = 154, 64.2 years), and control group (n = 141, 51.2 years). Additional biomarkers (transforming growth factor-β1 (TGF-β1) and glycated albumin) were determined from blood specimens in a subgroup of participants. AF patients exhibited lower levels of HDL, LDL and total cholesterol relative to controls, regardless of DM status. LDL-cholesterol was significantly more depressed in AF patients, particularly those with co-occurring DM. Triglyceride, fasting plasma glucose and HbA1c levels did not differ in the AF and control groups, and were the highest in the DM group, followed by AF+DM patients. TGF-β1 was depressed in AF patients, in contrast to its moderate level in AF+DM patients. Creatinine was significantly more elevated in AF patients, especially those with DM. AF patients also exhibited left atrial and ventricular enlargement, whether or not DM co-occurred. CONCLUSIONS: Findings suggest differential relationships between DM and AF with additive or interactive effects on some markers, including LDL, creatinine and TGF-β1, which could result in excess risk of adverse outcomes.
Raza A, Kaleem M, Kalpina F
… +7 more, Alamgir E, Rehmat M, Ahmad M, Fatima F, Shah AA, Turkmani M, Khan U
Am J Med Sci
· 2026 Apr · PMID 41276116
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BACKGROUND: Diabetes mellitus (DM) is a key risk factor for atherosclerotic cardiovascular diseases (ASCVDs), which remain a leading cause of morbidity and mortality worldwide. We aim to evaluate trends and disparities i...BACKGROUND: Diabetes mellitus (DM) is a key risk factor for atherosclerotic cardiovascular diseases (ASCVDs), which remain a leading cause of morbidity and mortality worldwide. We aim to evaluate trends and disparities in ASCVD-related mortality in US adults aged 45+ with DM from 1999-2019. METHODS: We extracted data from the CDC WONDER database using ICD-10 codes E10-E14 for DM and I25.0 and I25.1 for ASCVDs. Age-adjusted mortality rates (AAMRs) and crude death rates (CDRs) per 100,000 by sex, race/ethnicity, age group, and geographic regions were used. AAMRs and CDRs were analyzed using the Joinpoint Regression Program to calculate annual percentage changes (APCs) and average APCs (AAPCs). RESULTS: From 1999 to 2019, 453,572 ASCVD-related deaths occurred in 45+ year adults with DM. Overall, AAMR decreased from 22.22 to 16.11 [AAPC: -1.63 %, (-1.83 to -1.47)]. Females experienced a larger decline (AAPC -2.76 %) than males (-0.80 %). By race/ethnicity, non-Hispanic American Indians/Alaska Natives had the highest AAMR (32.36), and Asian/Pacific Islanders the lowest (12.85); Hispanics saw the steepest decline (-3.41 %). CDRs rose with age, from 3.16 (45-54 years) to 84.17 (85+), with the greatest decrease in the 65-74 group (-2.04 %). Regionally, the Midwest had the highest AAMR (19.86), and the South had the smallest decline (-1.44 %). Non-metropolitan areas had higher AAMRs (20.33) and smaller declines (-0.52 %) than metropolitan areas (18.17; -1.94 %). CONCLUSIONS: Our study reveals a decline in ASCVD-related mortality in DM patients in the US from 1999-2019. However, marked disparities persist across demographics and regions. Targeted health policy measures are needed to address these disparities.
Channey S, Kale-Pradhan P, Sharma M
… +4 more, Lebovic D, Giuliano C, Johnson L, Bhargava A
Am J Med Sci
· 2026 Mar · PMID 41276115
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BACKGROUND: Evusheld®, a combination of monoclonal antibodies Tixagevimab and Cilgavimab, was developed for pre-exposure prophylaxis (PrEP) of coronavirus disease 2019 (COVID-19) in immunocompromised patients. However, r...BACKGROUND: Evusheld®, a combination of monoclonal antibodies Tixagevimab and Cilgavimab, was developed for pre-exposure prophylaxis (PrEP) of coronavirus disease 2019 (COVID-19) in immunocompromised patients. However, real-world long-term data on its effectiveness against SARS-CoV-2 Omicron variants remain limited. METHODS: A retrospective cohort was conducted on patients ≥18 years old who received the Evusheld from December 1, 2021, to January 31, 2023, at six Ascension hospitals in Southeast Michigan. Patients included were those with active solid tumor and hematologic malignancies or undergoing immunosuppressive treatment, including CAR-T therapy, biologic agents, or high-dose corticosteroids (≥20 mg prednisone or equivalent per day for ≥2 weeks). Data collected included patient demographics, development of COVID-19 post-Evusheld, ICU length of stay (LOS), hospital LOS, ventilation requirement and duration, and mortality within six months post-therapy. RESULTS: Among 663 patients screened, 316 were included after excluding duplicates and patients that did not receive the ordered Evusheld regimen. Among them, 204 patients received two doses of Evusheld and 112 received only one dose. In the two-dose group, 18 (8.8%) tested positive for COVID-19 within 180 days post-Evusheld, while 11 (9.8%) in the one-dose group tested positive. Notably, none of the COVID-positive patients in either group required hospitalization, mechanical ventilation, or succumbed to the disease. CONCLUSIONS: Within six months of Evusheld administration, immunocompromised patients showed no episodes of rehospitalization, mechanical ventilation, or death, and experienced low rates of severe COVID-19.
Am J Med Sci
· 2026 Mar · PMID 41213382
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BACKGROUND: Diabetes mellitus (DM) is a metabolic disorder that lacks specific early diagnostic markers and is often associated with serious complications and comorbidities. The triglyceride-glucose index (TyG) and the t...BACKGROUND: Diabetes mellitus (DM) is a metabolic disorder that lacks specific early diagnostic markers and is often associated with serious complications and comorbidities. The triglyceride-glucose index (TyG) and the triglyceride-glucose-body mass index (TyG-BMI) are key metabolic indicators related to insulin resistance and β-cell dysfunction. However, their association with the development of type 2 diabetes mellitus (T2DM) remains unclear. This study aimed to examine the relationship between TyG and TyG-BMI levels and the incidence of T2DM, evaluate their predictive performance, and support the identification of populations at high risk for T2DM. METHODS: Data were obtained from the 2009 China Health and Nutrition Survey (CHNS), including 9498 participants. TyG and TyG-BMI were calculated, and their associations with T2DM risk were assessed using a Cox regression model. Predictive performance was evaluated with receiver operating characteristic (ROC) curve analysis. RESULTS: In the overall population, including both sexes, individuals aged >50 years and ≤50 years, and both urban and rural residents, higher TyG and TyG-BMI levels were independently associated with T2DM, showing a linear dose-response relationship. Both indicators demonstrated predictive value for T2DM, with TyG-BMI showing stronger associations, a larger area under the ROC curve, and greater clinical relevance. CONCLUSIONS: These results suggest that both TyG and TyG-BMI are useful predictors of T2DM, with TyG-BMI providing superior predictive accuracy. These findings support the use of these indices in the early screening of high-risk T2DM populations.
Bdiwi M, Patel N, Sattar Y
… +8 more, Titus A, Fakhra S, Erdem S, Manasrah N, Saleem A, Ahmed A, Rits M, Alraies MC
Am J Med Sci
· 2026 May · PMID 41202926
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BACKGROUND: Frailty has been linked to worse health outcomes, longer hospital stays, higher complications, and mortality. In general, higher morbidity and mortality especially with any invasive cardiac procedure. The imp...BACKGROUND: Frailty has been linked to worse health outcomes, longer hospital stays, higher complications, and mortality. In general, higher morbidity and mortality especially with any invasive cardiac procedure. The impact of frailty on TEER of MR is further explored in this study. METHODS: The NRD was queried between 2016-2020 to compare different outcomes between LF vs HF who underwent TEER. The multivariate regression was used to compare the primary and secondary outcomes between the two cohorts and generate univariate and multivariate odd ratios (OR) . STATA V.17 was used to compute the analysis. RESULTS: The total patients were 27,062 (HF 7,456 & LF 19,606). The mean age was 81.9±7.4 and 77.2±8.6 (P<0.001) in HF vs LF, respectively. The average LOS was higher in HF at 9.22±10.58 vs 2.12±2.7 days in LF. HF had higher and statistically significant values for the following outcomes in comparison with LF: in-hospital mortality (OR 21, [13.07-33.71,] P<0.001), AKI (OR 15.91, [13.49-18.77], P<0.001), CHF (OR 1.4, [1.17-1.68], P<0.001), MI (OR 8.42, [5.44-13.03], P<0.001), needs of MCS (OR 13.27, [8.28-21.25], P<0.001), MACCE (OR 14.13, [11.03-18.1], P<0.001), PPB (OR 2.42, [1.72-3.42], P<0.001), and CT (OR 3.99, [2.22-7.15], P<0.001). The median total cost of hospitalization was higher in HF patients ($51,374 [IQR 37,277-75,989]) in comparison with LF patients ($38,492 [IQR 29,713-50,030], P<0.001). CONCLUSIONS: HF individuals who underwent TEER of MR have higher in-hospital mortality, worse health outcomes and complications, longer hospital stay, and hence higher total healthcare costs in comparison with LF patients.
Dumanis G, Vaisman A, Issawy M
… +4 more, Gilboa M, Landau Zenilman C, Itelman E, Segal G
Am J Med Sci
· 2026 Mar · PMID 41202925
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BACKGROUND: Septic shock is a leading cause of mortality. Yet, blood cultures are negative in many cases, questioning the diagnosis. In the quest for characterization of "culture negative septic shock", the impact of chr...BACKGROUND: Septic shock is a leading cause of mortality. Yet, blood cultures are negative in many cases, questioning the diagnosis. In the quest for characterization of "culture negative septic shock", the impact of chronic vasodilating medications was questioned. METHODS: This was a retrospective analysis of patients with vital signs compatible with septic shock (fever > 37.9 or < 36 °C and systolic blood pressure < 90 mmHg). RESULTS: The study included 3,726 patients (ages 65 to 90). Of these, 1,382 (37.1%) took chronic vasodilators. This group of patients had a lower rate of positive blood cultures compared to the group that did not receive vasodilators (28.5% vs. 32%; P = 0.026). They were older (median 80 vs. 78 years; P = 0.001), and their background included more cardiovascular diseases (P < 0.001). Their total length of hospital stay was shorter (median 4 vs. 6 days; P < 0.001) yet, they had a higher risk of in-hospital mortality (39% vs. 35.1%; P = 0.019). Taking chronic vasodilators was associated with decreased risk for bacteremia by 16% (P = 0.023). Older age, positive bacterial culture, and chronic vasodilation treatment were independently associated with increased risk for in-hospital mortality by 3% (HR = 1.03, 95% CI 1.02 - 1.04; P < 0.001), 36% (HR = 1.36, 95% CI 1.18 - 1.57; P < 0.001), and 21% (HR = 1.21, 95% CI 1.05 - 1.4; P = 0.009) respectively. CONCLUSIONS: Chronic use of vasodilators amongst elderly patients presenting with fever and hypotension is associated with a higher incidence of negative blood cultures. We suggest these patients exhibit a combination of sepsis and shock rather than frank septic shock.
Am J Med Sci
· 2026 Apr · PMID 41201472
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Invasive Aspergillosis (IA) is a severe fungal infection primarily caused by Aspergillus species, notably Aspergillus fumigatus. However, newly emerging species, some exhibiting antifungal resistance, are becoming increa...Invasive Aspergillosis (IA) is a severe fungal infection primarily caused by Aspergillus species, notably Aspergillus fumigatus. However, newly emerging species, some exhibiting antifungal resistance, are becoming increasingly common. IA mainly affects immunocompromised individuals, including those with hematological malignancies and solid organ transplant recipients. In recent years, however, new at-risk populations have been identified, regardless of immune status, particularly those with severe viral infections requiring intensive care unit admission. This condition has gained prominence in intensive care unit settings following the recent H1N1 influenza and COVID-19 pandemics. Virus-associated pulmonary Aspergillosis (VAPA) encompasses two distinct entities: influenza-associated pulmonary Aspergillosis (IAPA) and COVID-19-associated pulmonary Aspergillosis (CAPA). These conditions are typically diagnosed in 10-20% of patients with severe influenza or COVID-19 when appropriate diagnostic methods are employed. Key diagnostic tools include bronchoalveolar lavage for fungal culture, galactomannan testing, and Aspergillus PCR, complemented by bronchoscopy to detect invasive Aspergillus tracheobronchitis visually. Azole antifungals are the first-line treatment, with liposomal amphotericin B serving as an alternative in regions with azole resistance. Despite antifungal interventions, IAPA and CAPA are linked to poor outcomes, with fatality rates often surpassing 50%. This review article discusses the pathophysiological mechanisms, clinical characteristics, diagnosis, and treatment of IAPA and CAPA. Additionally, it highlights key knowledge gaps and suggests potential areas for future research.
Zafar Y, Baker M, Muhammad A
… +8 more, Vicente DM, Mishoe RV, Mehaffey N, Petrasek J, Naseem Z, Azam H, Hafeez A, Javaid SS
Am J Med Sci
· 2026 Jan · PMID 41197898
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BACKGROUND: Between 2010 and 2016, alcohol-related liver disease (ALD) became the leading cause of nearly 1 in 3 liver transplants in the United States, surpassing hepatitis C. This condition is associated with high morb...BACKGROUND: Between 2010 and 2016, alcohol-related liver disease (ALD) became the leading cause of nearly 1 in 3 liver transplants in the United States, surpassing hepatitis C. This condition is associated with high morbidity and mortality across the country. We aim to study the trends and regional disparities in ALD-related mortality among adults in the United States. METHODS: Death certificates from the CDC WONDER database were examined from 1999 to 2020 for ALD-related mortality in adults ≥25 years. Age-adjusted mortality rates (AAMRs) per 100,000 persons and annual percent change (APC) were calculated and stratified by year, sex, race/ethnicity, urbanization, and geographic region. RESULTS: Between 1999 and 2020, 447,109 ALD-related deaths occurred among adults ≥25 years. The AAMR increased from 6.2 in 1999 to 15.7 in 2020. Men had consistently higher AAMR than women (AAMR; men: 14.1 vs women: 5.1). Non-Hispanic (NH) American Indian/Alaska Natives had the highest overall AAMR (43.7), followed by Hispanic (13.5), NH White (9.2), NH Black (7.2), and NH Asian/Pacific Islander (2.5) population. AAMR also varied substantially by region, with highest reported AAMR in West and lowest in Northeast, nonmetropolitan areas had higher ALD-related AAMR than metropolitan. States in the top 90th percentile of ALD-related AAMR were Washington, Alaska, and Oregon. CONCLUSIONS: Our study suggests an increasing trend in ALD-related mortality, especially among men, NH American Indian/ Alaska natives, and nonmetropolitan regions. Targeted strategies are needed to prevent and treat ALD among patients that are at risk to curb increasing levels of ALD-related mortality.
Am J Med Sci
· 2026 Mar · PMID 41177510
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Cardiac Sarcoidosis (CS) is a potentially life-threatening manifestation of sarcoidosis that presents significant diagnostic and management challenges. While only 2-5 % of patients with sarcoidosis are diagnosed with CS,...Cardiac Sarcoidosis (CS) is a potentially life-threatening manifestation of sarcoidosis that presents significant diagnostic and management challenges. While only 2-5 % of patients with sarcoidosis are diagnosed with CS, autopsy studies have demonstrated a prevalence as high as 25 % suggesting the condition is often under recognized likely because of lack of or nonspecific symptoms or diagnostic limitations. Considering the unreliability and invasiveness of endomyocardial biopsy, cardiac magnetic resonance imaging (CMR) and Fluorodeoxyglucose F18 (FDG) positron emission tomography (PET) have become useful diagnostic modalities in suspected cases of CS. However, there is scarce data in support of one imaging modality over the other and each has its limitations. Such limitations are depicted in the case of a patient with complete heart block and newly diagnosed sarcoidosis showing conflicting results on FDG-PET and CMR. A narrative review of current knowledge on this condition and about the imaging modalities available for the workup of CS is provided.
Am J Med Sci
· 2026 Feb · PMID 41176228
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Syphilis, an ancient malady, remains clinically relevant. Recent increases in syphilis cases, especially congenital syphilis, should increase the clinician's index of suspicion when presented with one of the protean clin...Syphilis, an ancient malady, remains clinically relevant. Recent increases in syphilis cases, especially congenital syphilis, should increase the clinician's index of suspicion when presented with one of the protean clinical syndromes associated with syphilis. Diagnosis and monitoring of response to treatment remain reliant on testing modalities with varying degrees of sensitivity and specificity, requiring clinical discernment. Penicillin remains the recommended treatment in most syphilis cases. New treatment options may be available soon.
Bennett CA, Almahal MA, Popovic K
… +2 more, Babiker A, Bronze MS
Am J Med Sci
· 2026 Feb · PMID 41173102
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Streptococci represent a diverse group of bacteria that create a wide range of clinical manifestations from suppurative skin and soft tissue infections, pharyngotonsillitis, and urinary tract infections to more severe in...Streptococci represent a diverse group of bacteria that create a wide range of clinical manifestations from suppurative skin and soft tissue infections, pharyngotonsillitis, and urinary tract infections to more severe infections such as bacteremia, meningitis and toxic shock syndrome. Group A streptococci also create immune mediated diseases, including acute rheumatic fever, rheumatic carditis, and poststreptococcal glomerulonephritis. Worldwide, these organisms are responsible for significant morbidity and mortality. While many species remain sensitive to penicillin, antibiotic resistance for some streptococci continues to rise. Preventive strategies are limited, but there is on-going research on developing safe and effective vaccines to prevent infections due to group A and group B streptococci. In this review, we discuss the emerging trends, clinical manifestations, issues of antibiotic resistance and what steps are used or might be used to prevent infection with these streptococci.
Xu Y, Zhang J, Lu Y
… +5 more, Zhang W, Shi H, Liang Q, Wang Y, Sun L
Am J Med Sci
· 2026 Mar · PMID 41173101
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OBJECTIVE: Sepsis remains a major global health challenge, with high mortality associated with multi-organ dysfunction, faster identification and assessment of sepsis is beneficial to guide treatment. Studies have found...OBJECTIVE: Sepsis remains a major global health challenge, with high mortality associated with multi-organ dysfunction, faster identification and assessment of sepsis is beneficial to guide treatment. Studies have found changes in the composition of bile acids (BAs) in the serum and stool of patients with sepsis compared to healthy individuals, so we sought to explore changes in serum BAs in patients with sepsis and their correlation with prognosis. METHODS: This prospective study enrolled healthy individuals and sepsis patients admitted to the Intensive Care Unit of the Second Affiliated Hospital of Nanjing Medical University between January 2023 and January 2024. Clinical data were collected, and serum levels of 15 BAs were quantified using liquid chromatography-tandem mass spectrometry. Patients were categorized into groups based on 28-day outcomes, severity of illness, and infection source for subsequent analysis. RESULTS: Compared with healthy individuals, the secondary BAs in sepsis patients were significantly lower, among which ursodeoxycholic acid (UDCA) is below the reference range. Compared with the survivors, the taurocholic acid (TCA) and taurodeoxycholic acid (TDCA) of the non-survivors of sepsis were significantly increased, while the UDCA was further decreased. Patients with pulmonary infection exhibited higher overall BA levels than those with abdominal infection. Both TCA and TDCA correlated positively with bilirubin, while UDCA correlated negatively with SOFA scores, C-reactive protein, and procalcitonin. In univariate COX regression, UDCA was associated with 28-day mortality (HR =0.990, P=0.042). ROC analysis showed that the area under the curve for UDCA predicting 28-day mortality was 0.643 (P=0.034). CONCLUSIONS: Secondary BAs were significantly reduced in sepsis patients, with UDCA showing the most pronounced decrease. This reduction becomes even more substantial in non-survivors. The overall BA levels were significantly higher in patients with pulmonary infection than in those with abdominal infection. UDCA was negatively correlated with SOFA score, CRP, and PCT in sepsis patients, and combining it with other indicators improves the prediction of sepsis prognosis. These results indicate that UDCA may exert a protective effect in sepsis.
Zhou H, Liu X, Wang K
… +4 more, Shu W, Ma M, Zhang X, Duan J
Am J Med Sci
· 2026 Mar · PMID 41138778
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BACKGROUND: Hemodynamic instability is a relative contraindication for noninvasive ventilation (NIV). However, there is limited evidence supporting this contraindication. METHODS: This prospective multicenter observation...BACKGROUND: Hemodynamic instability is a relative contraindication for noninvasive ventilation (NIV). However, there is limited evidence supporting this contraindication. METHODS: This prospective multicenter observational study across 18 Chinese and Turkish hospitals enrolled acute hypoxemic respiratory failure patients receiving NIV. Hemodynamic instability was defined as requiring vasoactive agents to maintain mean arterial pressure (MAP) >70 mmHg within 24 h of NIV. Reversible instability indicated vasoactive agent discontinuation by 24 h, while irreversible instability required persistent vasopressor use. RESULTS: Among 2137 enrolled patients, 279 (13 %) developed hemodynamic instability. Compared to hemodynamically stable patients, those with instability had significantly higher rates of NIV failure (56 % vs. 37 %; adjusted OR =1.89, 95 % CI: 1.37-2.59). NIV failure rates increased with the severity of hemodynamic impairment: 37 % in patients requiring no vasopressors, 54 % in those on one vasopressor, and 70 % in those requiring multiple vasopressors (p < 0.01 across groups). Within the unstable cohort, 55 patients (20 %) achieved hemodynamic stabilization within 24 h. Subsequent analysis showed that reversible instability was not significantly associated with NIV failure (adjusted OR =0.60, 95 % CI: 0.30-1.21), whereas irreversible instability was strongly associated with NIV failure (adjusted OR =2.48, 95 % CI: 1.75-3.53). CONCLUSIONS: Hemodynamic instability is associated with NIV failure. The likelihood of failure increases with the severity of the hemodynamic instability. However, if the instability is effectively reversed within the first 24 h, it is no longer associated with an increased risk of NIV failure.
Am J Med Sci
· 2026 Feb · PMID 41135848
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Influenza continues to challenge global health systems due to its evolving clinical and epidemiological features, with significant morbidity and mortality worldwide. Vaccine development remains a cornerstone of preventio...Influenza continues to challenge global health systems due to its evolving clinical and epidemiological features, with significant morbidity and mortality worldwide. Vaccine development remains a cornerstone of prevention, with attention to annual strain selection and enhanced formulations such as adjuvanted, high-dose, and recombinant vaccines. Promising innovations on the horizon include next-generation influenza vaccines, multi-pathogen vaccines, and universal influenza vaccines, with new technologies employing mRNA platforms and alternative vaccine administration strategies. The role of antivirals for prophylaxis and treatment are evaluated, including synergistic effects and resistance trends. Considerations for vulnerable populations with increased risk are highlighted. This review provides a timely synthesis of current knowledge and emerging strategies in diagnostics, therapeutics, and prevention to strengthen clinical outcomes and public health responses to influenza in the United States.
Am J Med Sci
· 2026 Feb · PMID 41135847
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The landscape of fungal infections is rapidly evolving. The global rise in incidence of fungal disease and the increasing prevalence of antifungal resistance can be attributed to shifting host factors and changes in path...The landscape of fungal infections is rapidly evolving. The global rise in incidence of fungal disease and the increasing prevalence of antifungal resistance can be attributed to shifting host factors and changes in pathogen dynamics. Candida species have shown increasing rates of invasive disease. This is accompanied by a growing number of resistant species, including Candida auris. While dermatophytes remain the most common cause of fungal disease, novel resistant species are emerging as a major cause of recalcitrant infections. Endemic mycoses are expanding beyond their previously defined geographic ranges, with newly recognized genera such as Emergomyces. Similarly, more resistant mold infections are affecting an increasingly immunocompromised patient population. These opportunistic fungal pathogens continue to be a major source of worldwide morbidity and mortality. Addressing this challenge requires an improved understanding of fungal epidemiology, a commitment to protecting vulnerable patients, and the development of novel antifungal agents.
Abid S, Pal A, Audil A
… +5 more, Humayun N, Ali O, Beers K, Feustel PJ, Mehta S
Am J Med Sci
· 2026 Jan · PMID 41130569
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BACKGROUND: Thrombotic microangiopathy (TMA) is a pathological diagnosis characterized by microvascular thrombosis, hemolytic anemia, thrombocytopenia, and ischemic organ dysfunction. The evolving understanding of TMA's...BACKGROUND: Thrombotic microangiopathy (TMA) is a pathological diagnosis characterized by microvascular thrombosis, hemolytic anemia, thrombocytopenia, and ischemic organ dysfunction. The evolving understanding of TMA's heterogeneous etiology, particularly in relation to genetic and complement dysregulation, complicates its diagnosis and management. METHODS: This retrospective study at Albany Medical Center (AMC) aimed to explore clinical outcomes and management strategies among 33 patients diagnosed with biopsy-confirmed TMA between 2018 and 2024. RESULTS: The cohort consisted of primary hereditary TMA (15.2 %), secondary TMA (69.7 %) and mixed etiologies (15.1 %). Gene panels were performed in 11 patients, revealing complement-related mutations in 9 cases. Of these, 5 had hereditary TMA, while 4 had mixed etiologies involving hereditary in addition to secondary or infectious triggers. Notably, 10 patients received complement inhibition, with 60 % showing improvement in kidney function at 6 months. DISCUSSION: This highlights the potential benefit of complement-targeted therapies, even in cases where secondary or mixed etiologies are suspected. The results raise the possibility that many secondary or infection-associated TMAs may harbor unrecognized complement-related abnormalities, emphasizing the importance of genetic testing and early complement inhibition in these cases. CONCLUSIONS: Future studies with larger cohorts are essential to further investigate these findings and refine diagnostic and therapeutic strategies for TMA, particularly in cases with complex or overlapping etiologies.