Am J Med Sci
· 2026 Jan · PMID 40945721
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Multiple Sclerosis (MS) is a complex neurological condition that requires an interprofessional approach to manage effectively. Primary care providers (PCPs) play a vital role in the management of MS as they represent the...Multiple Sclerosis (MS) is a complex neurological condition that requires an interprofessional approach to manage effectively. Primary care providers (PCPs) play a vital role in the management of MS as they represent the first line providers who can quickly and accurately recognize disease activity or worsening, assist patients with monitoring of disease burden and adequately address comorbidities that drive disease activity. This is especially true considering access constraints to specialists for patients residing in smaller communities. This article reviews how PCPs can recognize new disease activity versus pseudorelapse, can assist with medication monitoring, can support patients' needs for imaging surveillance and can recognize the importance of managing comorbid illnesses. As many patients travel quite a distance to tertiary care centers for MS management, PCPs may be asked to assist with labwork monitoring or imaging support.
Tomoda F, Kurosaki H, Sugimori H
… +4 more, Koike T, Ohara M, Nitta A, Kinugawa K
Am J Med Sci
· 2026 Jan · PMID 40935130
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BACKGROUND: The influences of blood viscosity on metabolism and the peripheral circulation have not been fully explored in obesity. We evaluated the impact of obesity on the associations of blood viscosity with those two...BACKGROUND: The influences of blood viscosity on metabolism and the peripheral circulation have not been fully explored in obesity. We evaluated the impact of obesity on the associations of blood viscosity with those two systems in non-diabetic subjects. METHODS: In 119 obese and 163 non-obese non-diabetic subjects, blood viscosity was measured using a falling-ball microviscometer. Homeostasis model assessment of insulin resistance (HOMA-IR) and blood lactate were also determined as indices for insulin resistance and anaerobic metabolism, respectively. RESULTS: Blood viscosity was significantly greater in the obese group than in the non-obese group (4.25±0.46 versus 4.14±0.44 mPa·S, p = 0.032). Blood viscosity was independently positively associated with log HOMA-IR and log blood lactate in the obese group, but not in the non-obese group. In all subjects, the body mass index status (i.e., non-obese or obese = 0 or 1) × blood viscosity interaction was significantly associated with log HOMA-IR and log blood lactate (partial r = 0.130, p = 0.029 and partial r = 0.173, p = 0.013). Thus, greater influences of blood viscosity on glucose and oxidative metabolism were observed in the obese group than the non-obese group. However, only approximately 9 to 11 % of the variance in blood viscosity was attributable to differences in log HOMA-IR or log blood lactate in the obese group. Contrastingly, blood viscosity did not relate with blood pressure in either group. CONCLUSIONS: In non-diabetic obesity, blood viscosity elevates, and such hemorheological change could at least partially contribute to the aggravations of insulin resistance and anaerobic metabolism.
Avidan Y, Aker A, Khoury R
… +2 more, Weizman B, Kassem S
Am J Med Sci
· 2025 Dec · PMID 40915632
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OBJECTIVE: Multifocal atrial tachycardia (MAT), characterized by an irregularly irregular rhythm, is often regarded as a clinical imitator of atrial fibrillation (AF). We aimed to evaluate the prevalence of MAT misclassi...OBJECTIVE: Multifocal atrial tachycardia (MAT), characterized by an irregularly irregular rhythm, is often regarded as a clinical imitator of atrial fibrillation (AF). We aimed to evaluate the prevalence of MAT misclassification as AF in the emergency department (ED) setting. METHODS: A retrospective analysis of 1828 ECGs from patients discharged with AF diagnoses over five years. All tracings were independently reviewed by three blinded cardiologists. RESULTS: MAT was identified in one case (0.05 %). Other misclassifications included atrial flutter (7.9 %), supraventricular tachyarrhythmias (1.6 %), and sinus rhythm with conduction disturbances, artifacts, or ectopy (1.0 %). CONCLUSIONS: Misdiagnosis of MAT as AF in the ED is rare. However, other diagnostic errors remain relatively common, underscoring the need for careful rhythm evaluation.
Cromer M, Domning K, Sullivan R
… +5 more, Aryan M, Petrie E, Ravi S, Beasley M, Shoreibah M
Am J Med Sci
· 2025 Dec · PMID 40914205
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BACKGROUND: Metabolic dysfunction-associated steatohepatitis (MASH) cirrhosis is now the second leading indication for liver transplantation (LT) worldwide and is associated with increased risk of cardiovascular events b...BACKGROUND: Metabolic dysfunction-associated steatohepatitis (MASH) cirrhosis is now the second leading indication for liver transplantation (LT) worldwide and is associated with increased risk of cardiovascular events before and after LT. Cirrhotics who undergo left heart catheterization (LHC) with coronary artery stenting for LT evaluation require dual antiplatelet therapy (DAPT). Data regarding the safety, risk of gastrointestinal (GI) bleeding, and mortality risk of cirrhotics receiving DAPT is limited. AIM: The objective of this study was to assess the risk of and outcomes related to GI bleeding in cirrhotics undergoing LT evaluation who received DAPT. METHODS: We conducted a retrospective review of adults with decompensated cirrhosis who underwent a LHC as part of LT evaluation between 2014 and 2021. RESULTS: A total of 291 patients were included. Thirty-three underwent LHC with coronary artery stenting and received DAPT, while 258 underwent LHC without intervention and received no DAPT. When comparing the DAPT and control groups, there were no significant differences in the following: GI bleeding on univariate analysis (9.09% vs 14.73%; p= 0.381) and multivariate analysis (odds ratio = 0.579; 95% confidence interval = 0.168 - 1.992; p = 0.386); recurrent GI bleeding (0% vs 4.26%; p = 0.227); variceal hemorrhage (3.03% vs 4.65%; p = 0.671); liver transplanation (30.30% vs 44.19%; p = 0.129); or 12-month mortality following GI bleeding (3.03% vs 5.81%; p = 0.509). CONCLUSIONS: Use of DAPT was not associated with an increased risk of GI bleeding or bleeding-related complications in decompensated cirrhotics with coronary artery disease undergoing LT evaluation.
Am J Med Sci
· 2026 Jan · PMID 40914204
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Hypertension is one of the most significant preventable health risk factors globally. Among its various forms, monogenic hypertension, although rare, warrants attention. As awareness of monogenic hypertension grows withi...Hypertension is one of the most significant preventable health risk factors globally. Among its various forms, monogenic hypertension, although rare, warrants attention. As awareness of monogenic hypertension grows within both the public and medical communities, research efforts are intensifying. Monogenic hypertension can primarily be categorized into three types: hypertension associated with abnormal distal renal tubular sodium transport, hypertension linked to adrenal steroid synthesis or receptor abnormalities, and other variants. These classifications are based on the functional impact and mutation type of the affected gene, with each category exhibiting distinct pathophysiological mechanisms and clinical manifestations. Recent advancements in gene sequencing technology have led to substantial progress in understanding monogenic hypertension. An increasing number of pathogenic genes have been successfully identified, providing a theoretical foundation for a deeper comprehension of the pathophysiological mechanisms underlying monogenic hypertension and for the development of novel treatment strategies.
Am J Med Sci
· 2026 Jan · PMID 40914203
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BACKGROUND: In transcatheter aortic valve replacement (TAVR), there is a notable "diabetes discrepancy", where worse/better/similar outcomes were all found for patients with diabetes mellitus (DM). Such divergent finding...BACKGROUND: In transcatheter aortic valve replacement (TAVR), there is a notable "diabetes discrepancy", where worse/better/similar outcomes were all found for patients with diabetes mellitus (DM). Such divergent findings pose a challenge for clinicians to accurately assess the risks for DM patients undergoing TAVR. We hypothesized the presence of chronic complications could be linked to worse post-TAVR outcomes in DM patients. Therefore, this study aimed to compare the short-term outcomes of TAVR between DM patients with chronic complications (DM-CC), those without complications (DM-NCC), and non-diabetic individuals (non-DM). METHODS: Patients who underwent TAVR were identified in National Inpatient Sample database from Q4 2015 to 2020. In-hospital post-TAVR outcomes were compared between DM-CC, DM-NCC, and non-DM. Multivariable logistic regression was used to adjust for demographics, socioeconomic status, primary payer status, hospital characteristics, transfer status, admission status, comorbidities and relevant diagnoses, and access site. RESULTS: There were 22,168 DM patients (9388 DM-CC and 12,780 DM-NCC) and 36,682 non-DM patients underwent TAVR. DM-CC were found to have worse outcomes than non-DM, which included adjusted risks of cardiac, neurological, pulmonary, and renal system complications, wound complications, hemorrhage, longer length of stay (LOS), and higher hospital charges. However, compared to non-DM, DM-NCC had lower in-hospital mortality, cardiac and renal system complications, infection, and superficial wound complications, as well as shorter LOS. CONCLUSIONS: The presence of diabetic chronic complications could be a hallmark for worse short-term outcomes after TVAR, which may unravel the long-debated "diabetes discrepancy" in TAVR and provide insights into preoperative risk stratification for DM patients.
Am J Med Sci
· 2026 Mar · PMID 40914202
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Vagus nerve stimulation (VNS) has gained significant attention as a therapy for various medical conditions due to its ability to modulate chronic diseases, pain, and inflammation. VNS delivered by an implanted device is...Vagus nerve stimulation (VNS) has gained significant attention as a therapy for various medical conditions due to its ability to modulate chronic diseases, pain, and inflammation. VNS delivered by an implanted device is FDA approved for severe epilepsy and refractory depression. VNS delivered with implantable devices or transcutaneous methods are now being studied in several musculoskeletal diseases including osteoarthritis, rheumatoid arthritis, systemic lupus erythematosus, and fibromyalgia. VNS activates the neuroimmune axis including the cholinergic anti-inflammatory pathway (CAP), suppressing inflammation and reducing pain. Here, we review the pathophysiology of VNS and the outcomes from clinical trials in musculoskeletal diseases. We address the limitations of these studies, including the inconsistent use of physiological biomarkers, such as heart rate variability, to ensure that VNS is engaging the vagus nerve. More studies are required to reveal the full potential of VNS for pain reduction and disease modification.
Am J Med Sci
· 2026 Mar · PMID 40885481
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BACKGROUND: Cardiovascular diseases (CVDs) are leading causes of mortality globally, with myocardial ischemia-reperfusion (I/R) injury being a critical challenge in clinical settings. Circular RNAs (circRNAs) have emerge...BACKGROUND: Cardiovascular diseases (CVDs) are leading causes of mortality globally, with myocardial ischemia-reperfusion (I/R) injury being a critical challenge in clinical settings. Circular RNAs (circRNAs) have emerged as significant molecular players in various pathophysiological conditions, including myocardial I/R injury. OBJECTIVE: This study aimed to investigate the role of circCOL3A1 in myocardial I/R injury and its potential regulatory mechanisms involving miR-29b-3p and MDM2. METHODS: Using a mouse model and H9c2 cardiomyocyte cells, we examined the expression levels of circCOL3A1 under I/R and hypoxia/reoxygenation (H/R) conditions. We utilized RT-qPCR, Western blotting, terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL), and dual-luciferase reporter assays to explore the interaction between circCOL3A1, miR-29b-3p, and MDM2. RESULTS: CircCOL3A1 was significantly downregulated in both I/R-treated mice and H/R-treated H9c2 cells. Overexpression of circCOL3A1 reduced apoptosis and improved cell viability by modulating the miR-29b-3p/MDM2 axis. These effects were reversed by overexpressing miR-29b-3p or silencing MDM2. CONCLUSIONS: CircCOL3A1 plays a protective role in myocardial I/R injury by acting as a miR-29b-3p sponge, thereby regulating the MDM2-mediated apoptosis pathway. This identifies circCOL3A1 as a potential therapeutic target for treating myocardial I/R injury.
Am J Med Sci
· 2025 Dec · PMID 40882804
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OBJECTIVE: Ascites is one of the common complications of hepatitis B virus (HBV) -related cirrhosis, which predicts a poor clinical prognosis for cirrhosis patients. Electrolyte disturbance is often observed in such pati...OBJECTIVE: Ascites is one of the common complications of hepatitis B virus (HBV) -related cirrhosis, which predicts a poor clinical prognosis for cirrhosis patients. Electrolyte disturbance is often observed in such patients. In our study, we developed a novel combined model integrating electrolyte indicators to evaluate the prognostic value of electrolyte indicators in ascites recompensation in HBV-related decompensated cirrhosis. METHODS: A retrospective cohort of 350 patients with HBV-related decompensated cirrhosis and ascites was categorized into recompensated (n = 117) and non-recompensated (n = 233) groups based on 2-year outcomes. Participants were randomly divided into training (n = 263) and validation (n = 87) cohorts. Multivariable logistic regression identified independent predictors, followed by nomogram construction. Model performance was assessed using receiver operating characteristic-area under the curve, calibration curves, and decision curve analysis. RESULTS: Serum chloride (OR = 1.08, P < 0.01), serum calcium (OR = 8.3, P < 0.01), and hepatic encephalopathy (HE) (OR = 0.06, P < 0.01) were independent predictors of recompensation. The nomogram demonstrated moderate predictive accuracy in the validation cohort (AUC = 0.762; 95 % CI: 0.653-0.871), with balanced sensitivity (59.3 %) and specificity (70.0 %). Calibration curves confirmed good agreement between predicted and observed outcomes (P > 0.05). DCA indicated superior clinical utility across risk thresholds (10-80 %). CONCLUSIONS: A nomogram integrating serum chloride, calcium, and HE effectively predicts recompensation in HBV-related decompensated cirrhosis with ascites, offering actionable guidance for clinical management.
Am J Med Sci
· 2025 Dec · PMID 40876770
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BACKGROUND: Raynaud's Syndrome (RS) is a vasospastic disorder characterized by intermittent episodes of arterial vasospasm of the extremities. The relationship between RS and cardiovascular outcomes is not well studied,...BACKGROUND: Raynaud's Syndrome (RS) is a vasospastic disorder characterized by intermittent episodes of arterial vasospasm of the extremities. The relationship between RS and cardiovascular outcomes is not well studied, particularly among hospitalized patients. This study aims to examine the relationship between RS and clinical outcomes among hospitalized patients. METHODS: The National Inpatient Sample (NIS) database was used to identify patients with RS using the ICD-10 code (RS: I73.0). Propensity score matching was performed to balance baseline demographic and clinical characteristics between patients with and without RS. CVD, rheumatological diseases, and inpatient outcomes were compared between the two groups before and after matching. RESULTS: RS patients had significantly higher rates of ischemic heart disease (22.9 % vs. 19.5 %; p < 0.01), heart failure (19.2 % vs. 14.5 %; p < 0.01), and pulmonary arterial hypertension (12.4 % vs. 4.0 %; p < 0.01). Rheumatological co-morbidities, including systemic sclerosis (14.6 % vs. 0.2 %; p < 0.01) and systemic lupus erythematosus (14.2 % vs. 0.8 %; p < 0.01), were more prevalent in RS patients. Inpatient complications, particularly acute decompensated heart failure (5.9 % vs. 4.5 %; p < 0.01), were more common in RS patients. CONCLUSIONS: Patients with RS had a higher prevalence of cardiovascular and rheumatological diseases and were associated with inpatient complications. These findings emphasize the importance of comprehensive cardiovascular and rheumatological disease risk assessment and inpatient monitoring in RS patients to optimize outcomes.
Am J Med Sci
· 2025 Dec · PMID 40854391
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BACKGROUND: Despite noteworthy developments and advancements in the field of cardiovascular medicine, myocardial infarction (MI) remains one of the leading causes of mortality worldwide. AIM: To investigate the existence...BACKGROUND: Despite noteworthy developments and advancements in the field of cardiovascular medicine, myocardial infarction (MI) remains one of the leading causes of mortality worldwide. AIM: To investigate the existence of disparities within MI-related locations of deaths in the United States. METHODS: Data on death certificates from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC-WONDER) was utilized to evaluate trends in the locations of MI-related mortality from 1999 to 2020. The following locations were considered: (i) inpatient facilities, (ii) outpatient/emergency facilities, (iii) decedent's home, and (iv) nursing or hospice facilities. RESULTS: A total of 2,858,426 MI-related deaths were utilized in this analysis. A steady decline in inpatient mortality was noted, along with a consistent increase in outpatient or emergency room (E.R.) mortality. The male sex was less likely to die in nursing or hospice facilities (OR: 0.44; P < 0.05). Younger individuals (<45 years) were more likely to die in outpatient/E.R. facilities (OR: 5.92; P < 0.05), whereas the elderly (85+ years) were more susceptible to nursing or hospice facilities. Non-Hispanic Black individuals were prone to death in outpatient/E.R. facilities (OR: 1.42; P < 0.05), whereas Non-Hispanic White individuals were more likely to die in nursing or hospice facilities. Additionally, rural areas had a higher risk of death at home (OR: 1.55; P < 0.05), whereas urban areas were more inclined towards inpatient mortality. CONCLUSIONS: This analysis identified several disparities and higher risk populations, emphasizing the need for better outreach to deliver practical management strategies in an equitable fashion.
Zhang TY, Fei LD, Wu JG
… +5 more, Zhu YQ, Li WZ, Wang SY, Xu XH, Yu L
Am J Med Sci
· 2025 Dec · PMID 40850520
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BACKGROUND: Gastroesophageal reflux-induced chronic cough (GERC) is a common cause of chronic cough, with an increasing incidence over the years. Proton-pump inhibitors (PPIs) are the standard treatment for GERC, but som...BACKGROUND: Gastroesophageal reflux-induced chronic cough (GERC) is a common cause of chronic cough, with an increasing incidence over the years. Proton-pump inhibitors (PPIs) are the standard treatment for GERC, but some patients exhibit poor response to PPIs. Vonoprazan, a potassium-competitive acid blocker (P-CAB), offers enhanced acid inhibition compared to PPIs and has shown effectiveness in treating GERC. However, its efficacy in refractory GERC cases has not been widely reported. METHODS: This report examines three cases of refractory GERC in which patients did not experience significant symptom relief after 8 weeks of PPI treatment. The treatment was switched to vonoprazan to evaluate its effectiveness in alleviating chronic cough symptoms. RESULTS: All three patients demonstrated complete relief from chronic cough after the transition to vonoprazan, indicating its potential effectiveness in cases where PPIs failed to provide sufficient symptom control. CONCLUSIONS: Vonoprazan is a promising clinical application in the treatment of refractory GERC.
Cai Y, Sun YF, Zhang QH
… +4 more, Zhang H, An P, Yu WJ, Xie FJ
Am J Med Sci
· 2025 Nov · PMID 40840654
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BACKGROUND: To address the challenge of delayed bacterial infection diagnosis in critically ill COVID-19 patients, we evaluated the performance of serum procalcitonin (PCT), C-reactive protein (CRP), and heparin-binding...BACKGROUND: To address the challenge of delayed bacterial infection diagnosis in critically ill COVID-19 patients, we evaluated the performance of serum procalcitonin (PCT), C-reactive protein (CRP), and heparin-binding protein (HBP), and bronchoalveolar lavage fluid HBP as potential biomarkers for guiding antibiotic therapy. METHODS: Patients meeting the inclusion criteria for severe and critical COVID-19 were enrolled as the case group, while age- and gender-matched healthy individuals were selected as the control group. Levels of PCT, CRP, and HBP were measured. The case group was further stratified based on bacterial culture results, and differences in serum, sputum, or bronchoalveolar lavage fluid markers were subjected to statistical analysis. RESULTS: Plasma levels of PCT and HBP were significantly higher in patients with bacterial infection compared to both the COVID-19 group and the healthy control group, while CRP was only significant in distinguishing cases from the healthy control group. The AUC for PCT in differentiating COVID-19 patients from those with bacterial infection was 0.937 with a sensitivity of 0.828 and specificity of 0.933, while the AUC for CRP was 0.564 with a sensitivity of 0.828 and specificity of 0.400. The AUC for HBP was 0.775 with a sensitivity of 0.690 and specificity of 0.967. The combined detection of PCT+CRP+HBP exhibited the highest diagnostic performance, with an AUC of 0.978, a sensitivity of 0.966, and a specificity of 0.933. CONCLUSIONS: The combined detection of PCT, CRP, and HBP can enable more precise classification of COVID-19 patients with concurrent bacterial infections and inform the optimal timing of antibiotic initiation.
Liu H, Yang M, Zhao Z
… +4 more, Zhang H, Gao C, Guo L, Hou S
Am J Med Sci
· 2025 Dec · PMID 40840653
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BACKGROUND: Sepsis-induced acute kidney injury (AKI) is a major global public health challenge. Key pathogenic mechanisms include inflammatory responses and renal tubular epithelial cell damage. The aryl hydrocarbon rece...BACKGROUND: Sepsis-induced acute kidney injury (AKI) is a major global public health challenge. Key pathogenic mechanisms include inflammatory responses and renal tubular epithelial cell damage. The aryl hydrocarbon receptor (AhR), a widely expressed protein receptor, has been reported to alleviate AKI upon activation; however, its precise mechanisms remain unclear. METHODS: Lipopolysaccharide (LPS) was used to establish sepsis-induced AKI models in vivo and in vitro. Protein expression was analyzed by western blotting, and histological staining was performed to assess tissue injury. RESULTS: AhR activation significantly attenuated LPS-induced AKI and reduced cell death following treatment with the AhR agonist 6-formylindolo[3,2-b]carbazole (FICZ). Mechanistically, FICZ decreased renal accumulation of malondialdehyde (MDA), 4-hydroxynonenal (4-HNE), and Fe²⁺, while upregulating glutathione peroxidase 4 (GPX4) and solute carrier family 7 member 11 (SLC7A11) expression. Furthermore, FICZ promoted AhR nuclear translocation, which subsequently enhanced nuclear factor erythroid 2-related factor 2 (NRF2) nuclear translocation and expression, ultimately mitigating LPS-induced cellular ferroptosis. CONCLUSIONS: This study demonstrates that AhR activation enhances NRF2 nuclear translocation and expression, thereby upregulating GPX4 and SLC7A11. This mechanism reduces intracellular lipid peroxide accumulation and suppresses ferroptosis, providing potential therapeutic targets for AKI treatment and translational research.
He Y, Li Y, Lao Q
… +3 more, Qin T, Xie X, Jiang W
Am J Med Sci
· 2025 Dec · PMID 40819715
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BACKGROUND: Currently, there is no definitive conclusion on the impact of standalone use of vitamin E in adult sepsis patients in the ICU on the 28-day mortality rate. This study hypothesizes that vitamin E can improve t...BACKGROUND: Currently, there is no definitive conclusion on the impact of standalone use of vitamin E in adult sepsis patients in the ICU on the 28-day mortality rate. This study hypothesizes that vitamin E can improve the prognosis of adult sepsis patients. METHODS: We analyzed adult sepsis patients (According to the international diagnostic criteria of sepsis 3.0) from the Medical Information Mart for Intensive Care IV Database (MIMIC-IV). A multivariate regression, propensity score analysis, and interaction effects were used to determine the associations between vitamin E intake and 28-day mortality rates in ICU. RESULTS: There was no significant reduction in 28-day mortality among patients who used vitamin E (treatment group) compared to those who did not use it (control group) in the preliminary observation and univariate analysis (hazard ratio = 0.89, 95 % confidence interval = 0.7-1.14, p = 0.361). After adjusting for all the covariates in multivariate Cox regression analysis, the hazard ratio is 0.75(95 % CI: 0.59∼0.95, p = 0.019). We also established two additional models for the relationship between vitamin E and mortality by adjusting different covariates. The adjusted HR values in model 1 and model 2 were 0.77 (95 % CI: 0.61-0.98, p = 0.035) and 0.75 (95 % CI: 0.59-0.96, p = 0.021), respectively. In the propensity score matching (PSM) model, we observed that the Multivariable-Adjusted, Propensity Score-adjusted, Weighted SMRW, Weighted PA, and Weighted Ow all have HR values <1, with p-values <0.05, and consistent trends in all results. CONCLUSIONS: In a general population of critically ill patients with adult sepsis, the use of vitamin E is associated with reduced 28-day mortality in ICU.
Am J Med Sci
· 2026 Jan · PMID 40812731
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Acute respiratory distress syndrome (ARDS) often occurs in the intensive care unit, and patients with ARDS have a poor prognosis due to severe hypoxemia caused by bilateral pulmonary oedema. Moreover, circulatory problem...Acute respiratory distress syndrome (ARDS) often occurs in the intensive care unit, and patients with ARDS have a poor prognosis due to severe hypoxemia caused by bilateral pulmonary oedema. Moreover, circulatory problems in patients with ARDS are a major concern for intensive care unit physicians. Due to increased pulmonary circulatory resistance, patients with acute respiratory distress syndrome usually exhibit increased right heart afterload, and patients with right heart failure usually develop Acute cor pulmonale(ACP). Prone ventilation is a common treatment for moderate-to-severe acute respiratory distress syndrome, and the prone position not only improves the patient's oxygenation index but also reduces pulmonary circulatory resistance and relieves circulatory pressure through multiple pathways. This article summarises the factors that increase pulmonary circulatory resistance in patients with ARDS and the circulatory benefits of prone ventilation. The purpose of this study was to provide assistance in the management of patients with ARDS.