The American journal of medicine
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For many years after its first description in 1924, thrombotic thrombocytopenic purpura was an intriguing puzzle for clinicians and researchers, not only for its unique pathology, perplexing changes in von Willebrand factor multimers, and high rate of rapid fatality but also for its dramatic response to plasma infusion or exchange. The discovery of ADAMTS13 (a disintegrin and metalloprotease with thrombospondin type 1 repeats member-13) and its deficiency in patients with thrombotic thrombocytopenic purpura, due to inhibitory autoantibodies or genetic mutations, provides a mechanistic scheme for understanding its pathogenesis. ⋯ Recently, caplacizumab, a bivalent nanobody targeting the glycoprotein 1b binding epitope of von Willebrand factor A1 domain, was approved as an addition to the current regimen of plasma exchange and immunomodulation for adult patients of acquired thrombotic thrombocytopenic purpura. This review discusses how the new treatment may improve patient outcomes and its potential pitfalls.
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While open access publishing among cardiovascular journals has increased in scope over the last decade, the relationship between open access and article citation volume remains unclear. ⋯ Among contemporary articles published in major cardiovascular journals, open access publishing accounted for over 40% of articles and was significantly associated with increased short-term citations. Further research is required to assess the variation in long-term citation rates based on open access publishing status.
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This study aimed to determine the association between cardiorespiratory fitness and healthcare expenditures among individuals with and without diabetes. ⋯ Higher fitness is associated with lower health care costs. Cost savings associated with higher fitness are particularly evident among individuals with diabetes. The economic burden of diabetes may be reduced through interventions that target improvements in fitness.
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Sex, race/ethnicity, and geographic disparities in sarcoidosis-associated mortality were assessed for the most recent period. ⋯ Sarcoidosis-related multiple cause of death mortality rates were highest in females and in non-Hispanic blacks, and they varied geographically.
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We aimed to evaluate the role of caffeinated beverage intake as a potential trigger of migraine headaches on that day or on the following day. ⋯ There was a nonlinear association between caffeinated beverage intake and the odds of migraine headache occurrence on that day. This suggests that high levels of caffeinated beverage intake may be a trigger of migraine headaches on that day.