Am. J. Med. Sci. [JOURNAL]
Sun
200 papers
BUB1B promotes gemcitabine resistance in lung adenocarcinoma and activates the PI3K/AKT signaling pathway.
Zeng QF, Chen YJ, Yang JP … +3 more , Zheng LP, Ye X, Xie Y
Am J Med Sci · 2025 Dec · PMID 40812730 · Publisher ↗
PURPOSE: Lung adenocarcinoma (LUAD) exhibits aggressive biological behavior and a poor prognosis. Gemcitabine is the first-line chemotherapy drug for advanced LUAD but has a low response rate. This study aims to explore...
PURPOSE: Lung adenocarcinoma (LUAD) exhibits aggressive biological behavior and a poor prognosis. Gemcitabine is the first-line chemotherapy drug for advanced LUAD but has a low response rate. This study aims to explore the effect of BUB1B on gemcitabine resistance in LUAD. METHODS: The data in the cancer genome atlas (TCGA) database was analyzed to clarify the expression of BUB1B in lung cancer and its relationship with clinical features. LUAD samples were collected to confirm BUB1B expression in lung cancer by qRT-PCR and Western Blot. The effects of gemcitabine on cell proliferation, apoptosis, and invasiveness were explored by overexpressing and silencing BUB1B in vitro and in vivo. Changes in PI3K/AKT were detected by Western Blot. RESULTS: BUB1B had higher expression in tumor tissues than in normal tissues and was associated with a worse prognosis (P < 0.05). The GSEA results showed that the G2m checkpoint and the PI3K / AKT pathway were differentially enriched in the LUAD samples. Inhibition of BUB1B expression affected proliferation activity, clone formation ability, and invasion ability of tumor cells. Meanwhile, inhibition of BUB1B expression increased tumor cell apoptosis rate and increased lung cancer cell sensitivity to gemcitabine among inhibition of the PI3K / AKT pathway. Furthermore, inhibition of BUB1B expression increased the sensitivity of lung cancer cells to gemcitabine, which was further validated in vivo. CONCLUSIONS: BUB1B may be a potentially useful prognostic molecular biomarker associated with poor survival in patients with LUAD and could regulate the sensitivity of lung cancer cells to gemcitabine and activates the PI3K/AKT pathway.
TGF-β induces a decrease in CAPZA1 expression to promote the invasiveness of hepatocellular carcinoma cells.
Xiao L, Cao L, Luo Z … +2 more , Zheng S, Huang D
Am J Med Sci · 2025 Nov · PMID 40796418 · Publisher ↗
BACKGROUND: CAPZA1 is underexpressed in hepatocellular carcinoma (HCC), and its downregulation promotes the epithelial-mesenchymal transition of HCC cells by regulating F-actin remodeling. However, the role of CAPZA1 in...
BACKGROUND: CAPZA1 is underexpressed in hepatocellular carcinoma (HCC), and its downregulation promotes the epithelial-mesenchymal transition of HCC cells by regulating F-actin remodeling. However, the role of CAPZA1 in enhancing the invasiveness of HCC cells and the mechanism underlying its low expression in this context remain unclear. Therefore, in the present study, we investigated the molecular mechanism underlying the downregulated CAPZA1 expression and its role in enhancing the invasiveness of HCC cells. METHODS: The molecular mechanism of TGF-β-induced low CAPZA1 expression was explored using in vitro and in vivo models. RNA interference and lentiviral infection were used to modulate CAPZA1 expression, and plasmid transfection was used to modulate GATA3 expression. We confirmed the transcriptional regulation of CAPZA1 by GATA3 through a ChIP assay. Additionally, we employed a FITC-gelatin degradation experiment to evaluate the invasiveness of HCC cells. Immunofluorescence analysis was used to examine the co-localization of F-actin with cortactin, as well as of F-actin with black spots in FITC-gelatin, thereby quantifying invadopodia of HCC cells. Finally, we observed the effect of the TGF-β/GATA3/CAPZA signaling pathway on HCC metastasis by inhibiting TGF-β with small-molecule inhibitors in nude mice. RESULTS: Downregulation of CAPZA1 promoted the invasiveness of HCC cells by regulating invadopodia marker expression, quantity, and function. GATA3 was identified as a transcription factor that regulates CAPZA1 expression, and TGF-β inhibited CAPZA1 expression by inducing low GATA3 expression. The small-molecule inhibitor SB431542, which targets the TGF-β signaling pathway, effectively suppressed HCC metastasis in nude mice and concurrently inhibited CAPZA expression in HCC tissues. CONCLUSIONS: TGF-β lowers the expression of the transcription factor GATA3, thereby downregulating CAPZA1 expression and enhancing the invasiveness of HCC cells, possibly by regulating invadopodia formation. Targeting the TGF-β/GATA3/CAPZA1 signaling pathway can effectively inhibit HCC metastasis.
Association between serum osmolality and the risk of ventilator-associated pneumonia in patients undergoing prolonged mechanical ventilation: a retrospective cohort study from MIMIC-IV database.
Wang M, Hu L, Zhang D … +2 more , Liu Y, Yang F
Am J Med Sci · 2025 Nov · PMID 40780505 · Publisher ↗
BACKGROUND: The study aimed to investigate the relationship between serum osmolality with the risk of ventilator-associated pneumonia (VAP) and in-hospital mortality in patients with prolonged mechanical ventilation (PMV...
BACKGROUND: The study aimed to investigate the relationship between serum osmolality with the risk of ventilator-associated pneumonia (VAP) and in-hospital mortality in patients with prolonged mechanical ventilation (PMV). METHOD: This study was a retrospective cohort study with data derived from the Medical Information Mart for Intensive Care database. Patients were categorized into two groups based on a serum osmolality cutoff of 295 mmol/L, with the reference group having values below 295 mmol/L. The primary outcome variable was the occurrence of VAP. The secondary outcome was in-hospital mortality. Logistic and Cox regression models assessed the effects of serum osmolality on VAP risk and in-hospital mortality, respectively, with sensitivity analysis conducted post-propensity score matching (PSM). RESULTS: The study included a total of 6749 patients a median follow-up duration along with the first and third quartiles of 9.23 (5.96, 15.95) days. Among the included patients, 574 cases of VAP occurred, and 1143 patients died in the hospital. The analysis revealed that compared to the reference group with serum osmolality <295 mmol/L, serum osmolality ≥295 mmol/L was associated with a higher risk of VAP occurrence [odds ratio (OR): 1.36, 95 % confidence interval (CI): 1.11-1.67] and a higher risk of in-hospital mortality [hazard ratio (HR): 1.22, 95 %CI: 1.06-1.40] (all P < 0.05). The analysis results after PSM matching were still significant (all P < 0.05). CONCLUSIONS: Serum osmolality at the initiation of ventilation significantly correlated with the risks of VAP occurrence and in-hospital mortality in patients on PMV. This study highlights the importance of maintaining serum osmolality for patients undergoing PMV.
Cardiovascular health and gender minority stress in transgender and gender diverse adults: A cross-sectional study.
Sowmiyanarayanan S, Karsan R, Deppe WL … +2 more , Binongo JN, Tangpricha V
Am J Med Sci · 2025 Nov · PMID 40774383 · Publisher ↗
BACKGROUND: Transgender and gender diverse (TGD) people may take gender affirming hormone therapy (GAHT) to affirm their gender identity and improve quality of life. The cardiovascular health (CVH) impacts of GAHT are no...
BACKGROUND: Transgender and gender diverse (TGD) people may take gender affirming hormone therapy (GAHT) to affirm their gender identity and improve quality of life. The cardiovascular health (CVH) impacts of GAHT are not well described. TGD individuals may also experience gender minority stress (GMS), typically caused by discrimination and transphobia, which may adversely affect CVH. The purpose of this study is to evaluate the CVH and gender minority stress of TGD adults receiving GAHT. METHODS: This observational study was approved by the Emory University Institutional Review Board. TGD adults (18-75 years) were recruited from Emory endocrinology outpatient clinics. CVH was measured using American Heart Association's Life's Essential 8 (LE8) tool. Data from electronic medical records were combined with administered questionnaire responses to calculate LE8 and GMSR scores. RESULTS: From October 2023 to April 2025, 98 TGD adults were screened and 95 were enrolled. Nine participants were excluded for incomplete questionnaires and/or medical records. Of 86 participants (mean age: 33.8 ± 1.4 years) with complete data, the mean LE8 score was 69.4 ± 1.3 and there was no significant difference based on sex assigned at birth. The lowest three sub scores were diet (37.7 ± 1.8), body mass index (BMI) (61.6 ± 4.0), and physical activity (63.4 ± 3.9), matching the lowest three subscores found in the general United States population. No statistically significant associations were found between GMSR and LE8 scores in this study. CONCLUSIONS: Factors beyond hormone therapy such as diet, BMI, and physical activity should be considered for driving CVH deficits in the TGD adult population. Further research is needed to understand longitudinal changes in CVH and the impact of GMS on CVH.
Effects of testosterone deficiency and therapy on the cardiometabolic syndrome in men.
Saad F, Traish AM
Am J Med Sci · 2025 Nov · PMID 40763842 · Publisher ↗
BACKGROUND: Testosterone (T) is a metabolic, sexual, and vascular hormone that has an important metabolic function in many tissues and organs and plays a key role in maintaining human physiology and health. A deficiency...
BACKGROUND: Testosterone (T) is a metabolic, sexual, and vascular hormone that has an important metabolic function in many tissues and organs and plays a key role in maintaining human physiology and health. A deficiency of T has detrimental effects on men's health and negatively impacts quality of life. T regulates differentiation, growth and function of muscle tissue and inhibits differentiation into adipocytes and fat accumulation; therefore, it regulates body composition. Thus, T deficiency (TD) may contribute to development of adiposity and metabolic syndrome (MetS). It should be noted that over the past 80 years, only 4 randomized clinical trials with a duration of three years or longer were reported. Hence, understanding the effects of long-term T therapy (TTh) on amelioration of MetS and its components would be attained mostly from observational and registry studies. METHODS: A comprehensive review of the current literature utilizing the NCBI library and PubMed were utilized using the key words "metabolic syndrome; testosterone deficiency; testosterone therapy". Relevant articles were retrieved and a summary of the potential relationship between TD and TTh and MetS were synthesized. RESULTS: The contemporary findings in the medical literature strongly suggest that TD is a predictor of onset of MetS and TTh ameliorates MetS components. Long-term data from several registry studies on the impact of TTh on MetS in men with TD demonstrated unequivocally that long-term TTh (up to 11 years) resulted in reductions in waist circumference (WC), fasting blood glucose, triglycerides (TGs), systolic and diastolic blood pressure and increased high-density lipoprotein cholesterol (HDL). In summary, long-term TTh in men with TD: 1) produces substantial and sustained weight loss; 2) prevents the progression from prediabetes to type 2 diabetes; 3) may result in remission of type 2 diabetes; 4) reduces fasting blood glucose; and 5) reduces cardiovascular events and mortality. CONCLUSIONS: In this narrative review, we summarize the available contemporary literature on the potential relationship between TD and development of MetS and discuss the findings of long-term TTh on amelioration of MetS components in men.
Acute asymptomatic C-reactive protein rise predicts short-term adverse events in peritoneal dialysis patients.
Kunin M, Mini S, Abu-Amer N … +1 more , Beckerman P
Am J Med Sci · 2025 Dec · PMID 40759367 · Publisher ↗
BACKGROUND: C-reactive protein (CRP) is an acute inflammatory protein that increases in association with acute and chronic inflammation due to a range of causes, including infectious diseases and noninfectious inflammato...
BACKGROUND: C-reactive protein (CRP) is an acute inflammatory protein that increases in association with acute and chronic inflammation due to a range of causes, including infectious diseases and noninfectious inflammatory disorders and also in metabolic stresses. The purpose of this work was to determine whether acute CRP elevations above the baseline level in asymptomatic peritoneal dialysis (PD) patients could be associated with future short-term adverse events. METHODS: Medical records of chronic PD patients between the years 2012-2022 were reviewed retrospectively. Cases of acutely increased serum CRP during regular patient visits without a clinical picture of inflammation or infection were collected. Follow-up analysis of each such elevated serum CRP test was performed. RESULTS: Overall 122 cases of acute increased CRP level were identified in patients who presented at regular visits in PD clinics without a clinical picture of infection or inflammation. Thirty-five patients (28.7%) developed an adverse event during the following month. CRP elevations that were associated with adverse events during the following month reached higher values compared to CRP elevations without adverse events, for any event - 58.97 ± 58.29 mg/l versus 31.67 ± 24.57 mg/l (p = 0.004), for severe event - 70.28 ± 62.26 mg/l versus 31.16 ± 24.67 mg/l (p = 0.001), for peritonitis - 54.95 ± 28.28 mg/l versus 37.81 ± 39.96 mg/l (p = 0.024) for hospitalization - 81.03 ± 72.27 mg/l versus 35.79 ± 32.91 mg/l (p = 0.010), and for the need for antibiotic treatment 70.40 ± 64.66 mg/l versus 33.07 ± 27.96 mg/l (p = 0.001). The area under the receiver operating characteristics (ROC) curve for serum CRP was 0.737 (range 0.606-0.869) for prediction of PD-related peritonitis (p = 0.007); 0.771 (range 0.639-0.902) for hospitalization (p = 0.005); 0.665 (range 0.552-0.778) for any adverse event (p = 0.005); 0.768 (range 0.664-0.873) for a severe adverse event (0.000) and 0.749 (range 0.631-0.868) for the need for antibiotic treatment (p = 0.000). Acute asymptomatic CRP elevations to a value above 50 mg/l were associated with increased risk of adverse events: Odd ratio was 3.119 (1.423, 6.836) p = 0.004 for any event, 4.727 (2.049, 10.904) p = 0.000 for severe event, 3.091 (1.064, 8.984) p = 0.038 for PD-related peritonitis, 5.023 (1.333, 18.931) p = 0.017 for hospitalization, and 3.698 (1.606, 8.518) p = 0.002 for antibiotic treatment. Multivariate analysis demonstrated that acutely elevated serum CRP above 50 mg/l was independently associated with any adverse event and severe adverse event during the next month after the elevation. Odd ratio was 2.769 (1.209, 6.343) p = 0.016 for any event and 4.065 (1.669, 9.902) p = 0.002 for severe adverse event. CONCLUSIONS: Acute increase of serum CRP above 50 mg/l among asymptomatic PD patients was associated with future short-term adverse event. Therefore, routine follow-up of CRP may be considered in PD patients.
Understanding sodium balance: the Edelman formula and its significance: a narrative review of the literature.
Flores J, Pena C, Nugent K
Am J Med Sci · 2025 Dec · PMID 40759366 · Publisher ↗
Clinicians have long faced challenges and decisions regarding sodium management in their patients. Clinicians must have a good understanding of the physiology of sodium, its metabolism, distribution in the body, and the...
Clinicians have long faced challenges and decisions regarding sodium management in their patients. Clinicians must have a good understanding of the physiology of sodium, its metabolism, distribution in the body, and the consequences of an increase or decrease in its normal level since changes in sodium levels occur frequently in different settings of patient care and across different specialties. Multiple studies and several formulas are currently available to help manage cases with abnormal sodium levels. These tools require a detailed focus to benefit patients in the short and long term and to avoid consequences due to poor decisions resulting in osmotic demyelination syndrome. This review will consider different aspects of sodium metabolism, the role sodium has in patients with edema, the evolution sodium management has had since the development of the Edelman formula and different variations of his formula, and other considerations regarding sodium storage in the skin are currently relevant for a more in-depth approach to the management of patients with dysnatremias.
Pyoderma gangrenosum-like ulcer association in small vessel vasculitis (Vasculitis presenting as pyoderma gangrenosum-like ulcer).
Marzuk Z, Homsi Y, Moshiri AS … +1 more , Karagounis TK
Am J Med Sci · 2025 Nov · PMID 40759365 · Publisher ↗
Pyoderma gangrenosum (PG) was first described by French Dermatologist Louis-Anne-Jean Brocq as a "rapidly spreading ulceration of soft tissue". Histologically, PG is a neutrophilic dermatosis presenting as painful ulcera...
Pyoderma gangrenosum (PG) was first described by French Dermatologist Louis-Anne-Jean Brocq as a "rapidly spreading ulceration of soft tissue". Histologically, PG is a neutrophilic dermatosis presenting as painful ulcerations. It is known to be associated with autoimmune-mediated disorders such as vasculitis. Timely confirmatory diagnosis with tissue biopsy and management with immunosuppressive agents are critical. We report a unique case of a PG-like lesion related to small vessel vasculitis in a 47-year-old man. Following the initiation of methotrexate (Methotrexate) therapy, the patient's lesions improved significantly, highlighting the importance of recognizing PG-like lesions associated with vasculitis.
Prognostic role of the pulmonary artery-to-aorta ratio and the N-terminal of prohormone brain natriuretic peptide in patients hospitalized with bronchiectasis exacerbation.
Seo H, Cha SI, Park J … +9 more , Lim JK, Park JE, Choi SH, Lee YH, Yoo SS, Lee SY, Lee J, Kim CH, Park JY
Am J Med Sci · 2025 Dec · PMID 40759364 · Publisher ↗
BACKGROUND: Information regarding the role of the N-terminal of prohormone brain natriuretic peptide (NT-proBNP) and the ratio of the diameter of the pulmonary artery to the diameter of the aorta (PA:A ratio) on computed...
BACKGROUND: Information regarding the role of the N-terminal of prohormone brain natriuretic peptide (NT-proBNP) and the ratio of the diameter of the pulmonary artery to the diameter of the aorta (PA:A ratio) on computed tomography in predicting prognosis in patients with bronchiectasis exacerbation is limited. METHODS: Retrospectively, patients with bronchiectasis exacerbation were classified into survivors and non-survivors based on 1-year mortality. Clinical, laboratory, and radiological variables were compared between the two groups. RESULTS: Based on 1-year mortality, patients (n = 389) were classified as non-survivors (67 [17.2 %]) or survivors (322 [82.8 %]). Age, body mass index <18.5 kg/m, ≥3 exacerbations in the previous year, NT-proBNP >404 pg/mL, and PA:A ratio >1 were independent predictors of 1-year mortality in patients hospitalized with bronchiectasis exacerbation. In terms of the prognostic performance of various factors for predicting 1-year mortality using receiver operating characteristic curves, NT-proBNP had the highest area under the curve, followed by PA:A ratio. Furthermore, the prognostic performance of the Bronchiectasis Severity Index, FACED score, NT-proBNP, and PA:A ratio in predicting 1-year mortality was assessed in 198 patients with spirometry results. Among these variables, the Bronchiectasis Severity Index exhibited the highest area under the curve, followed by NT-proBNP and PA:A ratio. CONCLUSIONS: PA:A ratio and NT-proBNP may be valuable biomarkers for predicting 1-year mortality in patients with bronchiectasis exacerbation.
Trends and disparities in hypertension-related mortality among adults with obesity in the United States from 2000-2023.
Qureshi S, Khan TM, Salim H … +6 more , Uddin MS, Imran Z, Ali D, Sajid M, Siddiqui H, Waqas SA
Am J Med Sci · 2025 Nov · PMID 40759363 · Publisher ↗
INTRODUCTION: Obesity and hypertension are major public health concerns in the United States (US), significantly contributing to mortality. Despite their well-established association, long-term trends and demographic dis...
INTRODUCTION: Obesity and hypertension are major public health concerns in the United States (US), significantly contributing to mortality. Despite their well-established association, long-term trends and demographic disparities in hypertension-related mortality among individuals with obesity remain underexamined. This study evaluates these trends, focusing on variations by sex, race, geographic region, and urbanization level. METHODS: Mortality data from individuals aged ≥25 years with obesity (ICD-10-CM: E66) and hypertension (ICD-10-CM: I10-I15) as underlying or contributing causes of death were extracted from the CDC WONDER database (2000-2023). Age-adjusted mortality rates (AAMRs) were calculated across demographic subgroups. Joinpoint regression estimated the average annual percentage change (AAPC). Sensitivity analyses assessed trends when hypertension was the primary cause of death. RESULTS: Between 2000 and 2023, 410,416 hypertension-related deaths occurred in individuals with obesity. AAMR increased from 2.58 per 100,000 in 2000 to 13.23 in 2023 (AAPC: +7.16 %, 95 % CI: 6.66-8.52, p < 0.001). Males had higher AAMRs than females, with NH Black individuals experiencing the highest mortality rates. Nonmetropolitan areas and Southern US had significantly higher AAMRs. Mortality spiked between 2019 and 2021, likely due to COVID-19, before declining in 2023. DISCUSSION: The rising hypertension-related mortality in individuals with obesity highlights the growing burden of cardiometabolic disease. The COVID-19 pandemic exacerbated these trends, but recent declines suggest potential benefits from improved public health measures. CONCLUSIONS: Hypertension-related mortality in individuals with obesity has risen substantially, with significant disparities by sex, race, and geography. Targeted interventions are needed to address these disparities and reduce obesity-related hypertension mortality.
The new ReDS system for fluid management: The clinical application status and prospect.
Xu M, Kan J, Xing Y … +2 more , Ma Q, Sun Y
Am J Med Sci · 2025 Dec · PMID 40759362 · Publisher ↗
Volume assessment is a critical and challenging clinical skill, especially in cardiology, emergency departments, and intensive care units. The right heart catheterization is the only gold standard to evaluate the volume,...
Volume assessment is a critical and challenging clinical skill, especially in cardiology, emergency departments, and intensive care units. The right heart catheterization is the only gold standard to evaluate the volume, and there is currently a lack of rapid, non-invasive, and accurate methods to quantify pulmonary congestion. The remote dielectric sensing system (ReDS) is a non-invasive technique based on electromagnetic energy, which can quantify the percentage of lung fluid concentration in the body within one minute. Although ReDS technology was created 10 years ago, it has been only in the past 3 years that ReDS technology has gradually become more widely used in the clinic. Many patients with heart failure, lung infections, and perioperative have benefited. The purpose of this article is to introduce the new technology of ReDS and its current clinical application and prospects. It is hoped that it can provide more research ideas for clinicians and provide basis for further research on more diseases.
Predictive value of cardiac markers, atherogenic index of plasma and cardiometabolic index for coronary heart disease in type 2 diabetes mellitus patients with normal body mass index.
Yang T, Cao H, Yuan X
Am J Med Sci · 2025 Nov · PMID 40738322 · Publisher ↗
BACKGROUND: Prior research has established type 2 diabetes mellitus (T2DM) as a risk factor for the onset of coronary heart disease (CHD). Nevertheless, the impact of abnormal lipid metabolism on the development of CHD i...
BACKGROUND: Prior research has established type 2 diabetes mellitus (T2DM) as a risk factor for the onset of coronary heart disease (CHD). Nevertheless, the impact of abnormal lipid metabolism on the development of CHD in individuals with a normal body mass index (BMI) remains uncertain. The objective of our study was to examine risk factors for CHD in T2DM patients with normal BMI and construct predictive model. METHODS: Multivariate logistic and LASSO regression analyses were utilized to examine the independent risk factors associated with CHD. A calibration, decision curve analysis (DCA), and precision-recall (PR) curves were employed to assess the model's goodness of fit. RESULTS: Seven independent risk factors, namely the duration of T2DM, FBG, HbA1c, NT-proBNP, sST2, AIP, and CMI, contributed to the development of CHD in T2DM patients with normal BMI by logistic and LASSO regression analysis. These factors were utilized to construct a robust and dependable nomogram model for predicting CHD risk with the likelihood-ratio test (χ = 309.52; P < 0.001), C index (0.964; 95 % CI: 0.945 - 0.983; P < 0.001), and hosmer-lemeshow goodness fit (χ = 3.7675; P = 0.878). CONCLUSIONS: Our findings indicated that impaired lipid metabolism in T2DM patients with a normal BMI is closely linked to the onset of CHD. Effective management strategies, including strict glycemic control, vigilant monitoring of myocardial markers, and regulation of blood lipids and visceral fat, are essential for reducing the incidence of CHD in T2DM patients with normal BMI.
Rheumatologic manifestations in an X-Linked chronic granulomatous disease carrier.
Hudson KQ, Barker CS, Oates JC … +1 more , Williams KW
Am J Med Sci · 2025 Oct · PMID 40712698 · Publisher ↗
Chronic granulomatous disease (CGD) is a rare immunologic disorder caused by a defective nicotinamide adenine dinucleotide phosphate (NADPH) oxidase complex which consequentially causes immunodeficiency due to an inabili...
Chronic granulomatous disease (CGD) is a rare immunologic disorder caused by a defective nicotinamide adenine dinucleotide phosphate (NADPH) oxidase complex which consequentially causes immunodeficiency due to an inability to clear some bacteria and fungi. As with many other X-linked genetic conditions, X-linked chronic granulomatous disease (XL-CGD) carriers were thought to be genetic conveyors of disease but not clinically affected. However, recent literature has revealed that XL-CGD carriers can have a marked and debilitating clinical phenotype. Herein, we describe various rheumatologic manifestations in a female X-linked CGD carrier with skewed Lyonization. Her story underscores the autoimmune and inflammatory phenomena that can be associated with XL-CGD carrier state and the complexity of treatment considerations for these manifestations.
Corrigendum to "Associations between psoriasis, psoriatic arthritis and gout or hyperuricemia: A systematic review and meta-analysis" [Am J Med Sci. 369 (2025) 671-678].
Liu Z, Ma X, Chang T … +6 more , Yao C, Song M, Biyue S, Zhang F, Liu J, Jiang Q
Am J Med Sci · 2026 Jul · PMID 40701436 · Publisher ↗
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Corrigendum to "Clinical trial participation among underserved communities: Insights from the Louisiana Community Engagement Alliance" [Am J Med Sci. 366 (2023): 254-262].
Craig LS, Sarpong DF, Peacock EM … +9 more , Theall KP, Williams L, Al-Dahir S, Davis TC, Arnold CL, Williams A, Fields T, Wilson M, Krousel-Wood M
Am J Med Sci · 2025 Oct · PMID 40701435 · Publisher ↗
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Corrigendum to "COVID-19 vaccination likelihood among federally qualified health center patients: Lessons learned for future health crises" [Am J Med Sci. 366 (2023) 321-329].
Peacock E, Craig LS, Wilson M … +17 more , Williams L, Al Dahir S, Tang W, Cyprian A, Dery M, Gilliam D, Nguyen D, Smith K, Valliere M, Williams S, Wiltz G, Winfrey K, Davis T, Arnold C, Theall K, Sarpong D, Krousel-Wood M
Am J Med Sci · 2025 Oct · PMID 40701434 · Publisher ↗
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Association of family history of myocardial infarction or stroke with vascular parameters in healthy individuals: the EVasCu study and MUJER-EVA project.
Cavero-Redondo I, Pascual-Morena C, Martínez-Hortelano JA … +5 more , Álvarez-Bueno C, Martínez-García I, Rodríguez-Gutiérrez E, Bizzozero-Peroni B, Saz-Lara A
Am J Med Sci · 2025 Oct · PMID 40680933 · Publisher ↗
BACKGROUND: The role of a family history of cardiovascular events in predisposing patients to cardiovascular diseases is recognized. Arterial stiffness, as measured by pulse wave velocity (PWv), is an emerging risk indic...
BACKGROUND: The role of a family history of cardiovascular events in predisposing patients to cardiovascular diseases is recognized. Arterial stiffness, as measured by pulse wave velocity (PWv), is an emerging risk indicator. This study explores the association between a family history of cardiovascular events (i.e., myocardial infarction and stroke) and vascular and blood pressure parameters in healthy individuals. METHODS: The cross-sectional EVasCu study in Cuenca, Spain, enrolled 390 healthy adults. Vascular (aortic PWv [aPWv], cardio-ankle vascular index [CAVI], ankle-brachial index [ABI], augmentation index [AIx@75]) and blood pressure (systolic blood pressure [SBP], diastolic blood pressure [DBP], pulse pressure [PP]) parameters, as well as other covariates, were measured. ANOVA and ANCOVA were used to assess the association between family history of myocardial infarction and stroke and vascular and blood pressure parameters. RESULTS: The study group included 246 females and 144 males (Age: 42.05 ± 13.15 years). According to the unadjusted analyses, a family history of myocardial infarction was associated with increased SBP and PP (p = 0.015 and p = 0.012, respectively), with PP remaining significantly elevated in females (p = 0.003). These associations were largely attenuated after adjustment for sociodemographic, clinical, and lifestyle variables; however, PP remained significantly greater in females with a family history of myocardial infarction (p = 0.030), as supported by z score normalization (p = 0.036). Additionally, a family history of stroke was associated with significantly increased aortic pulse wave velocity (aPWv) in both the total sample and in females (p < 0.001 and p = 0.002, respectively), findings that remained significant after z score adjustment. CONCLUSIONS: Arterial stiffness emerges as a potential bridge between genetic predisposition and cardiovascular risk. Recognizing the importance of a family history of cardiovascular events in risk assessment and leveraging noninvasive measures of arterial stiffness could refine preventive strategies.
Presence of chronic complications differentiates in-hospital outcomes of transjugular intrahepatic portosystemic shunt in patients with diabetes mellitus.
Li R, Lee S, Rienas W … +1 more , Sarin S
Am J Med Sci · 2025 Oct · PMID 40680932 · Publisher ↗
BACKGROUND: Transjugular intrahepatic portosystemic shunt (TIPS) is an interventional radiological procedure to reduce portal hypertension. Hyperglycemic state in diabetes mellitus (DM) is associated with vascular injuri...
BACKGROUND: Transjugular intrahepatic portosystemic shunt (TIPS) is an interventional radiological procedure to reduce portal hypertension. Hyperglycemic state in diabetes mellitus (DM) is associated with vascular injuries that can lead to chronic complications, which is implicative of the extent/control of DM. This study aimed to use chronic complications as a marker for uncontrolled DM and examine major in-hospital outcomes after TIPS among DM patients with (DM-WCC) and without chronic complications (DM-WOCC). MATERIALS: Patients who underwent TIPS were identified in the National Inpatient Sample (NIS) from Q4 2015-2020. DM-WCC and DM-WOCC were identified using the Elixhauser comorbidity measure. In-hospital post-TIPS outcomes between DM-WCC, DM-WOCC, and non-DM patients were compared using multivariable logistic regression. RESULTS: NIS identified 1199 DM-WOCC, 1229 DM-WCC, and 4230 non-DM. Compared to non-DM, DM-WOCC had lower in-hospital mortality (aOR=0.661, 95 CI=0.493-0.885, p = 0.01) and renal complications (aOR=0.632, 95 CI=0.534-0.749, p < 0.01). Compared to non-DM, DM-WCC had higher renal complications (aOR=1.366, 95 CI=1.174-1.591, p < 0.01) and hepatic encephalopathy (HE; aOR=1.378, 95 CI=1.189-1.597, p < 0.01). Compared to DM-WOCC, DM-WCC had higher mortality (aOR=1.452, 95 CI=1.025-2.057, p = 0.04), renal complications (aOR=2.165, 95 CI=1.774-2.641, p < 0.01), and HE (aOR=1.247, 95 CI=1.045-1.487, p = 0.01). DM-WOCC had shorter length of stay and less total hospital costs than both DM-WCC and non-DM. CONCLUSIONS: The presence of chronic complications in DM may differentiate the risk of complications after TIPS, where DM-WCC patients had worse outcomes, while DM-WOCC seems to be protective. Managing diabetic chronic complications may be helpful to avoid adverse outcomes after TIPS.
Exploring the obesity parADOX: A multisystem review.
Aggrawal K, Gupta V, Singh B … +4 more , Medatwal R, Singh S, Jain P, Jain R
Am J Med Sci · 2025 Oct · PMID 40680931 · Publisher ↗
Obesity has plagued the entire world and is a known risk factor across the spectrum of diseases involving neurological, cardiovascular, pulmonary, gastrointestinal, and hematological and is commonly associated with poor...
Obesity has plagued the entire world and is a known risk factor across the spectrum of diseases involving neurological, cardiovascular, pulmonary, gastrointestinal, and hematological and is commonly associated with poor clinical outcomes. Obesity paradox is a concept that contradicts the prevailing medical knowledge by proposing the notion that obese patients have better mortality, morbidity, and survival rates when compared to the non-obese patient population suffering with the similar medical conditions. Although observed more commonly in patients with cardiovascular diseases, more research is coming forward citing the similar effects in critically ill patients, those with chronic kidney disease, end stage renal disease, and cancer patients. Despite extensive research, the underlying mechanisms of the Obesity Paradox remain unclear, complicated by the reliance on BMI and the neglect of confounding factors like age, comorbidities, socioeconomic status, and one of the commonly proposed solutions is to make use of other anthropological indices of obesity. This calls for a more in-depth dive into this issue to find an explanation behind this paradox or even more to confirm if it actually exists.
Utility of glucagon-like-peptide-1-receptor agonists in mast cell activation syndrome.
Afrin LB, Weinstock LB, Dempsey TT … +3 more , Aschenbrenner K, Blitshteyn S, Schofield JR
Am J Med Sci · 2025 Oct · PMID 40675372 · Publisher ↗
INTRODUCTION: Mast cell (MC) activation syndrome (MCAS) is a collection of illnesses rooted in inappropriate MC activation with little to no neoplastic MC proliferation, distinguishing it from mastocytosis. Due to great...
INTRODUCTION: Mast cell (MC) activation syndrome (MCAS) is a collection of illnesses rooted in inappropriate MC activation with little to no neoplastic MC proliferation, distinguishing it from mastocytosis. Due to great heterogeneity in the underlying MC regulatory gene mutational profiles present in most cases and resulting great heterogeneity in aberrant expression of the hundreds of potent mediators known to be expressed by MCs, MCAS presents with great heterogeneity but dominantly manifests as chronic multisystem polymorbidity of generally inflammatory, allergic, and dystrophic phenotypes. MCAS's heterogeneity at multiple levels poses challenges for identifying optimal individual treatment. Targeting commonly affected downstream effectors of the disease's various symptoms may yield clinical benefit independent of the root/upstream mutational profile in the individual patient. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) engage with GLP-1 receptors present on many types of cells, including MCs. These drugs are already approved for management of a few chronic inflammatory diseases (e.g., diabetes mellitus type 2, obesity, obstructive sleep apnea) but are increasingly being appreciated to help in a wide range of other inflammatory diseases. METHODS: We present the first case series showing utility of a variety of GLP-1RAs for managing refractory MCAS in a diverse assortment of such patients. RESULTS: Among 47 cases (mean age 39, range 15-71, 89 % female), 89 % demonstrated clinical benefit with GLP-1RAs for a broad range of problems associated with MCAS. CONCLUSION: GLP-1RAs may have substantial benefit in MCAS. Randomized controlled trials are needed to assess the efficacy, and identify optimal dosing, of GLP-1RA treatment in MCAS.
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