The American journal of the medical sciences
-
Primary pulmonary lymphoma (PPL) is a rare type of lymphoma, representing <1 % of all primary lung cancers. Mucosa associated lymphoid tissue (MALT) lymphoma, the most common type of PPL, has an indolent slow growing course over years leading to frequent misdiagnoses. ⋯ A transthoracic biopsy confirmed it as MALT lymphoma. This case highlights the unusual manifestation in MALT lymphoma (being in disguise for a decade prior to diagnosis), thus emphasizing the role of meticulous evaluation of prior medical records and biopsy.
-
Data from pivotal randomized controlled trials established the four pillars of guideline-directed medical therapy in heart failure with reduced ejection fraction. The randomized controlled trials enrolled stable patients with New York Heart Association functional class II-III and a low incidence of cardiovascular death and hospitalization for heart failure. ⋯ We review the observational studies that point to the fading benefit of neurohormonal modulation and cardiac afterload reduction in the late stages of cardiovascular or renal diseases. We then propose a pragmatic approach for collecting evidence-based data on sequential withdrawal of the four pillars in patients with heart failure and reduced ejection fraction after years of guideline-directed medical therapy.
-
The American Heart Association recently defined cardio-kidney-metabolic (CKM) syndrome as the intersection between metabolic, renal, and cardiovascular disease. Understanding the contemporary estimates of CKM related mortality in the US is essential for developing targeted public interventions. ⋯ In the US, CKM mortality disproportionately affects more socially deprived counties. Inability to reduce CKM mortality rates over the study period highlights the need for targeted policy interventions to curb the ongoing high burden.
-
The study aimed to investigate the impact of varying thyroid function statuses on clinical and laboratory indicators in patients with systemic lupus erythematosus (SLE). ⋯ The correlation between thyroid function and the severity of SLE is significant, SLE patients with hypothyroidism exhibit more pronounced disease manifestations and an elevated risk of organ damage. SLE patients with low levels of FT3 and FT4 are prone to progressing to nephritis.