The American journal of medicine
-
Massive animal farming for meat production poses major problems in terms of resource use, environmental impact, and biodiversity. Furthermore, excessive meat consumption has been associated with multiple deleterious health consequences. ⋯ Novel meat alternatives, such as plant- and cell-based meat, are much less impactful to the environment and might replace traditional animal meat in the future, but, despite promising early data, the health consequences of these novel products need further study. This manuscript focuses on the health impacts of meat over 3 main sections: 1) overview of the evidence highlighting the association of meat consumption with health; 2) novel alternatives to meat, including plant-based and cell-based alternatives; and 3) examine the rationale for randomized studies to evaluate the effects of the novel meat alternatives compared with the standard animal meat.
-
Coffee is one of the most widely consumed beverages globally. A substantial number of observational data suggest an inverse relationship between coffee consumption and the risk for cardiovascular disease. The basis for this association is not clear. In this review, we specifically study the impact of coffee on inflammatory biomarkers as one potential mechanistic basis for this observation. Our objective was to systematically review randomized controlled trials that examined the effects of coffee consumption on selected cardiovascular biomarkers. ⋯ Based on our systematic review of randomized controlled studies, we cannot confidently conclude that an anti-inflammatory effect of coffee is a major contributing factor to the lower all-cause mortality reported in observational studies.
-
Primary care physicians are in a favorable position to curb the growing burden of pancreatic ductal adenocarcinoma. This review aims to provide an overview of pancreatic ductal adenocarcinoma from a primary care perspective, with a specific focus on risk factors, selection of high-risk individuals for screening, patient presentation at the primary-care clinic, and the role of the internist in supportive care. Overall, the internist is an essential member of the multidisciplinary care team with respect to optimizing patients' quality of life across various stages of the pancreatic cancer.
-
Cardiac amyloidosis is increasingly recognized as an underdiagnosed cause of heart failure. Diagnostic delays of up to 3 years from symptom onset may occur, and patients may be evaluated by more than 5 specialists prior to receiving the correct diagnosis. ⋯ Better awareness among primary care providers of the clinical presentation and modern treatment landscape is essential to improve timely diagnosis and early treatment of this disease. In this review, we provide practical guidance on the epidemiology, clinical manifestations, diagnostic evaluation, and treatment of transthyretin and light chain cardiac amyloidosis to promote earlier disease recognition among primary care providers.
-
Review
Ending Racial Bias in American Medicine: A Call for Help from the AMA, NMA, AAMC and the Rest of Us.
Bias based on skin color, religion, immigrant status, gender, and ethnicity are deeply rooted in American culture and have existed within the infrastructure of American medicine from the beginning. Now, medical educators are struggling to find curriculum and experiences that effectively address explicit and implicit bias among our increasingly diverse group of students, house staff, and practitioners. The leadership, experience, and lessons learned needed to scrub present medical school curricula of racial bias, to develop an antiracist curriculum, and to test its effectiveness already lies with the American Medical Association (AMA), the Association of American Medical Colleges (AAMC), and the National Medical Association (NMA). We call on these organizations to jointly convene a consortium of medical educators, social scientists, curricular specialists, and others to chart a way forward to assist medical schools and professional organizations in developing evaluable curricular materials and experiences to eliminate bias in health care.