The American journal of medicine
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Medicine has separated the two cultures of biological science and social science in research, even though they are intimately connected in the lives of our patients. To understand the cause, progression, and treatment of long COVID , biology and biography, the patient's lived experience, must be studied together.
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Multicenter Study
Oral Anticoagulant Use for Patients with Atrial Fibrillation with Concomitant Anemia and/or Thrombocytopenia.
Hemoglobin levels and platelet counts have been associated with adverse clinical outcomes in patients with cardiovascular conditions. We aimed to assess the impact of oral anticoagulant use for patients with atrial fibrillation and concomitant anemia or thrombocytopenia. ⋯ Patients with atrial fibrillation with anemia or thrombocytopenia were a high-risk population. Compared with no OAC use, NOACs were associated with better clinical outcomes for patients with atrial fibrillation and advanced anemia (hemoglobin <10g/dL) or thrombocytopenia (platelet <100 K/µL) but not for those with both conditions.
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Review
ATRIAL FIBRILLATION: IS RHYTHM CONTROL REQUIRED, AND IF SO, HOW, AND WHAT IS THE INTERNIST'S ROLE?
Atrial fibrillation-no primary care physician can escape it. Atrial fibrillation is the most common tachyarrhythmia encountered in clinical practice-whether family practice, internal medicine, cardiology, pulmonology medicine, etc. Moreover, with growth of the older segment of our population and better survival of patients with cardiovascular disorders, the incidence and prevalence of atrial fibrillation are both increasing progressively. ⋯ The latter is the most complex of the 4, and many, if not most, primary care physicians currently prefer to leave this "pillar" to the care of a cardiologist or electrophysiologist. Nonetheless, it is important for the primary care physician to be familiar with the rhythm treatment components and choices (both overall and, specifically, the ones in which they must participate) as they will impact many interactions with their patients in multiple ways. This review details for the primary care physician the components of care regarding rhythm control of atrial fibrillation and the areas in which the primary care physician/internist must be knowledgeable and proactively involved.
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Sickle cell trait is typically considered benign. Although evidence remains inconsistent, recent studies suggest that it is associated with several common diseases. We systematically assessed associations of sickle cell trait with reported diseases in a large population-based cohort. ⋯ Sickle cell trait is significantly associated with increased risk for diabetes and diabetes-related complications/comorbidities.