Journal of investigative medicine : the official publication of the American Federation for Clinical Research
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Hypomagnesemia associates with inflammation and risk of diabetes and hypertension, which may contribute to kidney function decline. We hypothesized that low serum magnesium (SMg) levels independently associate with a significant decline in estimated glomerular filtration rate (eGFR). We analyzed SMg levels in 2056 participants from the Dallas Heart Study, a longitudinal, population-based, multiethnic, cohort study involving residents of Dallas County, Texas, USA. ⋯ Every 0.2 mg/dL (0.08 mM) decrease in SMg was associated with an eGFR decline of -0.23 mL/min/1.73 m2 per year (95% CI -0.38 to -0.08; p=0.003), a decline that was more pronounced in participants with prevalent diabetes compared with patients without diabetes (-0.51 vs -0.18 mL/min/1.73 m2 per year, respectively). In conclusion, low SMg was independently associated with eGFR decline. Further studies are needed to determine whether Mg repletion can ameliorate inflammation, lower blood pressure and serum glucose and ultimately prevent or retard kidney function decline.
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The goals of this study were to develop a new prediction model to predict 1-year poor prognosis (death or modified Rankin scale score of ≥3) in patients with acute ischemic stroke (AIS) and to compare the performance of the new prediction model with other prediction scales. Baseline data of 772 patients with AIS were collected, and univariate and multivariate logistic regression analyses were performed to identify independent risk factors for 1-year poor prognosis in patients with AIS. The area under the receiver operating characteristics curve (AUC) value of the new prediction model and the THRIVE, iScore and ASTRAL scores was compared. ⋯ The AUC value of the new prediction model was higher than the THRIVE score (p<0.05). The χ2 value for the Hosmer-Lemeshow test was 7.337 (p>0.05), suggesting that the prediction model had a good fit. The new prediction model can accurately predict 1-year poor prognosis in Chinese patients with AIS.
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To examine how to increase research career outcomes among medical graduates, we analyzed the impact of the Research Scholarly Concentration at The George Washington University School of Medicine and Health Sciences. Residency placement, subsequent scholarship, and career outcomes were compared among 670 graduates who participated in the elective Clinical and Translational Research Scholarly Concentration or no Concentration between 2009 and 2018. We conducted a retrospective study of residency match (highly selective vs less selective), job type (academic vs non-academic), and postmedical school publications (any vs none). ⋯ Surprisingly, the length of research experience before medical school was not associated with these outcomes among Research Scholarly Concentration graduates. This suggests that a medical school Research Scholarly Concentration is effective in training physician researchers and should be available to both novices and research-experienced matriculants. These data suggest how other medical schools might plan Scholarly Concentration programs to improve research outcomes among medical graduates.
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This study aims to investigate the association between pulmonary embolism (PE) and the risk of psychiatric disorders. A total of 21,916 patients aged ≥20 years with PE between January 1, 2000, and December 31, 2015, were selected from the National Health Insurance Research Database of Taiwan, along with 65,748 (1:3) controls matched for sex and age. Cox regression model revealed the crude HR was 1.539 (95% CI 1.481 to 1.599; p<0.001), and after adjusting all the covariates, the adjusted HR was 1.704 (95% CI 1.435 to 1.991, p<0.001), for the risk of psychiatric disorders in the PE cohort. ⋯ PE was associated with the overall psychiatric disorders, dementia, anxiety, and depression, after the exclusion of the psychiatric diagnoses in the first 5 years. The patients with PE were associated with psychiatric disorders. This finding could serve as a reminder to the physicians to be more watchful and aware in the long-term follow-up of patients with PE for their care and potential mental health problems.
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Research on atrial histology of humans without cardiovascular disease is scarce. Therefore, our aim was to study human atrial histology in subjects without cardiovascular disease. Histology of the right atrium, left atrium or atrial septum was studied in eight patients (one newborn infant and seven adults) who died of a non-cardiac cause and who were not known to suffer from any cardiovascular pathology. ⋯ Furthermore, we identified a perpendicular orientation of atrial myocardial fibres, which is also a feature of the thin RV free wall. A similar histologic substrate to the RV myocardium known in ARVD is found in the atria of humans without an overt cardiovascular pathology. This may explain the high prevalence of atrial fibrillation in the general population.