Culturally Congruent Latino-Adapted Telemonitoring of Underrepresented Adults With Type 2 Diabetes: The CULTURA-DM2 Trial.

This study reports on the development and testing of a comprehensive diabetes telemonitoring program tailored to meet the needs of underserved Hispanic/Latino patients with diabetes. Individuals participating in the culturally tailored program had significantly better 6-month outcomes than those receiving comprehensive outpatient management for A1C, blood pressure, and diabetes self-efficacy, with no differences between groups in quality of life, medication adherence, emotional functioning, patient activation, or unscheduled physician visits. These findings suggest that culturally congruent diabetes telemonitoring may be effective for this underserved population.

Echocardiography as a Useful Tool for Differentiating Acute Pulmonary Embolism From Acute Coronary Syndrome: A Case Report.

Both acute coronary syndrome (ACS) and pulmonary embolism (PE) are life-threatening medical emergencies with overlapping symptoms and laboratory findings. Differentiating these two emergencies and initiating proper treatment are of paramount importance for good outcomes. In this report, we present the case of a 60-year-old male with a history of seizure disorder and hyperlipidemia, who presented to the emergency department (ED) after a syncopal episode preceded by three days of brief episodes of chest pain.

Culture-Negative Endocarditis Complicated by Cerebral Abscesses Due to Streptococcus gordonii: A Diagnostic Odyssey.

Endocarditis is a serious diagnostic entity that carries a high rate of morbidity and mortality, with complications including heart failure, septic embolization, brain abscesses, and stroke. Blood culture-negative endocarditis (BCNE) represents a particularly challenging clinical scenario where the causative organism is undetectable, either due to being difficult to culture or due to the empiric administration of antimicrobial agents. This entity generally results in delayed diagnosis and treatment of endocarditis, with a potential increase in the rate of complications.

Granulomatous Mastitis: An Initial Presentation of Undiagnosed Prolactinoma.

Granulomatous lobular mastitis (GLM) is a rare, benign inflammatory disease of the breast that shares some physical diagnostic features with breast cancer. GLM has been rarely reported to be associated with prolactinoma. In this report, we present a case of undiagnosed prolactinoma in a 37-year-old woman with its initial presentation as GLM.

Differential Effect of Hyperglycemia on the Odds of Cancer Among the Adult Population of the United States.

Objective Accumulating evidence indicates a relationship between diabetes and cancer risk, with obesity, insulin resistance, and hyperglycemia being implicated as the major underlying pathogenetic mechanisms of increased cancer risk among people with diabetes. We aim to assess the differential effect of dysglycemia (prediabetes and diabetes) on the strength of association (odds) of cancer amongst the adult US diabetic population.  Material and methods We analyzed data from the 1997-2013 National Health Interview Survey (NHIS) dataset, which applies a multistage area probability sampling design.

The impact of diabetes mellitus on HIV virologic control: results of the MACS/WIHS combined cohort study.

Objective: Diabetes mellitus (DM) is associated with lower antiretroviral (ART) drug exposure among persons with HIV (PWH) compared to PWH without DM. The association between DM and virologic control in PWH, however, remains unknown.

Methods: We included participants in the Multicenter AIDS Cohort Study/Women's Interagency HIV Study Combined Cohort Study (MWCCS) who had initiated ART between 1999 and 2020 and had a suppressed HIV viral load (≤200 copies/ml) within 1 year of ART initiation.

Crisis in the Chest: Acute Chest Syndrome as a Sequela of Tricuspid Valve Endocarditis.

The management of acute chest syndrome (ACS) in sickle cell disease occurring concurrently with pulmonary embolism resulting from tricuspid valve endocarditis poses an atypical challenge. We present a case in which this complex interaction occurs and the prompt interventions that were utilized to give the best possible outcome.

Successful Percutaneous Coronary Intervention in a Patient With Absent Right Coronary Artery Ostium: A Case Report and Literature Review.

Coronary artery anomalies present unique interventional challenges, particularly when associated with significant coronary artery disease. This case report contributes to the limited literature on congenital coronary artery anomalies, emphasizing the need for tailored approaches to optimize patient care. We present a case of a 70-year-old male with refractory angina and a rare congenital coronary anomaly characterized by the absence of the right coronary artery ostium, necessitating reliance on the left coronary system for myocardial perfusion.

Type 2 diabetes and health-related quality of life among older Medicare beneficiaries: The mediating role of sleep.

Objective: To examine mediating effects of sleep quality and duration on the association between T2D and QoL among Medicare beneficiaries 65+.

Methods: Data from the Medicare Health Outcome Survey (2015-2020) were used. The outcome was QoL (physical and mental health component-summary scores [PCS and MCS]) measured by the Veterans-Rand-12.

Myocardial Bridging of Mid-left Anterior Descending Artery (LAD) Presenting As Transient Left Bundle Branch Block During Nuclear Stress Test.

Transient left bundle branch block occurring during a nuclear stress test in the setting of myocardial bridging is a relatively rare finding. We report a case of a 75-year-old male who presented with typical stable angina. Serial troponins were negative, and the electrocardiogram revealed normal sinus rhythm with left ventricular hypertrophy and T-wave inversions in the lateral leads.

Ensuring fidelity: key elements to consider in disseminating a diabetes telemanagement program for underserved Hispanic/Latinos living with type 2 diabetes.

Background: The Hispanic/Latino population has greater risk (estimated >50%) of developing type 2 diabetes (T2D) and developing it at a younger age. The American Diabetes Association estimates costs of diagnosed diabetes in 2017 was $327 billion; with medical costs 2.3x higher than patients without diabetes.

The Role of Triglycerides in Atherosclerosis: Recent Pathophysiologic Insights and Therapeutic Implications.

Triglycerides have long been recognized as a cardiovascular disease risk factor. However, their precise role in atherosclerosis and potential utility as a therapeutic target remains debated topics. This review aims to shed light on these aspects by exploring the complex relationship between triglycerides and atherosclerosis from pathophysiological and pharmacological perspectives.

Gabapentin-Induced Myoclonus in a Patient With Chronic Kidney Disease.

Gabapentin contains a cyclohexyl group and is a form of gamma-aminobutyric acid (GABA). Despite its name, gabapentin does not affect the inhibitory neurotransmitter GABA or its receptors. Instead, it acts as a ligand, binding strongly to the α2δ (Ca) channel subunit and interfering with its regulatory function and the release of excitatory neurotransmitters.

Spontaneous Pneumothorax in a Young Female With Lymphangioleiomyomatosis.

Lymphangioleiomyomatosis (LAM) is a rare disorder of abnormal proliferation of smooth muscle-like cells which results in the formation of thin-walled cysts and progressive lung destruction. It commonly presents with progressive dyspnea that is often associated with a history of pneumothorax or chylothorax particularly among females of reproductive age. In this report, we present a case of hydropneumothorax as the initial presentation of LAM in a 33-year-old woman, a rather rare presentation.

Sarcoidosis Versus Lymphoma: A Clinical Diagnostic Dilemma in a Patient With Extensive Lymphadenopathy.

Sarcoidosis is a granulomatous disease involving multiple organ systems. In its classic form, sarcoidosis is associated with non-caseating granuloma. Several differential diagnostic entities exist for sarcoidosis, including tuberculosis (TB), as well as lymphomas.

A Rare Case of Central Retinal Artery Occlusion in the Setting of Patent Foramen Ovale.

Patent foramen ovale (PFO) is a congenital heart anomaly with persistent non-closure of the atrial septum that generally closes six to 12 months after birth in the majority of adults. While remaining asymptomatic in the majority of cases, PFO could lead to paradoxical embolism and cryptogenic strokes in most symptomatic cases. The incidence of small arterial occlusion due to paradoxical emboli is quite uncommon.

Association of marijuana, tobacco and alcohol use with estimated glomerular filtration rate in women living with HIV and women without HIV.

Objective: Marijuana, tobacco and alcohol use are prevalent among people with HIV and may adversely affect kidney function in this population. We determined the association of use of these substances with estimated glomerular filtration rate (eGFR) among women with HIV (WWH) and women without HIV.

Design: We undertook a repeated measures study of 1043 WWH and 469 women without HIV within the United States Women's Interagency HIV Study, a multicenter, prospective cohort of HIV-seropositive and HIV-seronegative women.

Low Bone Mass and Recurrent Fractures in Neurofibromatosis With Concomitant Hemoglobin SC Disease.

Bone disease and bone loss are common features in certain monogenic diseases such as RASopathies, including neurofibromatosis (NF). Similarly, bone complications are frequent in hemoglobinopathies, another group of Mendelian diseases. This paper reports a young patient with both NF and hemoglobin SC (HbSC) diseases who had multiple vertebral fractures with osteopenia.

COVID-19 stressors for Hispanic/Latino patients living with type 2 diabetes: a qualitative study.

Background And Aim: During the early stages of the COVID-19 pandemic, nationwide lockdowns caused disruption in the diets, physical activities, and lifestyles of patients with type 2 diabetes. Previous reports on the possible association between race/ethnicity, COVID-19, and mortality have shown that Hispanic/Latino patients with type 2 diabetes who are socioeconomically disadvantaged are disproportionately affected by this novel virus. The aim of this study was to explore stressors associated with changes in diabetes self-management behaviors.

Kaposi Sarcoma: A Rare Presentation of Elephantiasis Nostras Verrucosa.

Although a low-grade vascular tumor, Kaposi sarcoma (KS) can have mucosal, and visceral involvement. Additionally, disfiguring disseminated lesions can be seen in patients with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). KS may cause lymphatic obstruction leading to chronic lymphedema that further contributes to progressive cutaneous hypertrophy and severe disfigurement in the form of non-filarial elephantiasis nostras verrucosa (ENV).

A Novel Finding of Increased ß-Aminoisobutyric Acid Levels in Classic Homocystinuria With Homocysteine-Lowering Treatment.

Hyperhomocysteinemia is an independent risk factor for cardiovascular disease. Although commonly seen as a milder elevation of homocysteine levels in adult patients, on rare occasions, the internist may face extremely elevated homocysteine levels (>100 µmol/L). In such rare cases, the search for a monogenic disease is warranted.