TRANSCULTURAL DIABETES CARE IN THE UNITED STATES - A POSITION STATEMENT BY THE AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS.

The American Association of Clinical Endocrinologists (AACE) has created a transculturalized diabetes chronic disease care model that is adapted for patients across a spectrum of ethnicities and cultures. AACE has conducted several transcultural activities on global issues in clinical endocrinology and completed a 3-city series of conferences in December 2017 that focused on diabetes care for ethnic minorities in the U.S.

Transthyretin Cardiac Amyloidosis in Black Americans.

Transthyretin-related cardiac amyloidosis is a progressive infiltrative cardiomyopathy that mimics hypertensive and hypertrophic heart disease and often goes undiagnosed. In the United States, the hereditary form disproportionately afflicts black Americans, who when compared with whites with wild-type transthyretin amyloidosis, a phenotypically similar condition, present with more advanced disease despite having a noninvasive method for early identification (genetic testing). Although reasons for this are unclear, this begs to consider the inadequate access to care, societal factors, or a biological basis.

A Comparison of Vasodilating and Non-vasodilating Beta-Blockers and Their Effects on Cardiometabolic Risk.

Cardiometabolic risk describes a collection of risk factors, with a likely underlying pathophysiology, resulting in accelerated atherosclerosis and the terminal cardiovascular events of myocardial infarction and stroke. Beta-blockers, which are divided as vasodilators or non-vasodilators, are used in the treatment of hypertension and other cardiovascular diseases. Vasodilators have been shown to be of particular benefit in both blood pressure control and other cardiometabolic components with limited disturbance in metabolic parameters.

2014 hypertension recommendations from the eighth joint national committee panel members raise concerns for elderly black and female populations.

A report from panel members appointed to the Eighth Joint National Committee titled "2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults" has garnered much attention due to its major change in recommendations for hypertension treatment for patients ≥60 years of age and for their treatment goal. In response, certain groups have opposed the decision to initiate pharmacologic treatment to lower blood pressure (BP) at systolic BP ≥150 mm Hg and treat to a goal systolic BP of <150 mm Hg in the general population age ≥60 years. This paper contains 3 sections-an introduction followed by the opinions of 2 writing groups-outlining objections to or support of maintaining this proposed strategy in certain at-risk populations, namely African Americans, women, and the elderly.

Community-based approaches to prevention and management of hypertension and cardiovascular disease.

Community hypertension (HTN) outreach seeks to improve public health by identifying HTN and cardiovascular disease (CVD) risks. In the 1980s, the National Heart, Lung, and Blood Institute (NHLBI) funded multiple positive community studies. Additionally, the Centers for Disease Control and Prevention's (CDC's) Racial and Ethnic Approaches to Community Health (REACH) program addresses CVD risks.

Acinetobacter endocarditis presenting as a large right atrial mass: an atypical presentation.

This paper discusses a 26-year-old woman with end-stage renal disease on hemodialysis and Acinetobacter calcoaceticus-baumannii complex endocarditis. The patient had an indwelling right internal jugular catheter that was probably the nidus of infection. Transthoracic echocardiogram revealed an atypical presentation of the endocarditis as a large intracardiac mass, measuring in centimeters and occupying more than 50% of the right atrial cavity.

Symptomatic metastatic right atrial lymphoma in a patient with AIDS presenting with pulmonary embolization.

Tumors involving the heart are rare, and the majority of them are benign. Secondary lymphoma with localization to the heart is the third most common malignant heart tumor and is more common, by far, than primary cardiac lymphomas. In patients with human immunodeficiency virus, the risk of development of systemic lymphoma is 60 to 200 times higher than in the general population.

Inflammatory aneurysm of the thoracoabdominal aorta with associated dissection.

The inflammatory variant of aortic aneurysms has 3 unique features: marked thickening of the aneurysm wall, fibrosis of the adjacent retroperitoneum, and rigid adherence of the adjacent structures to the anterior aneurysm wall. Abdominal tenderness with or without a pulsatile abdominal mass is the most common finding, although it is present in only about 33% of patients. Systemic symptoms, such as fever, malaise, and weight loss, are reported in about 20% to 50% of patients.