SMJ // Medicine & Medical Specialties

Medicine & Medical Specialties

Encompasses the entire field and disciplines of internal medicine, as well as family medicine and general medicine. Addresses the wide-range of non-surgical diseases and disorders (diagnosis and treatment), pharmacological therapy, evidence-based practice, and interdisciplinary patient care.

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SMJ Article | Multidisciplinary Clinical Case Study

Undiagnosed HIV in Patients on Immunosuppressive Medications Presenting with HIV-Associated Kidney Disease

Approximately 158,500 adults and adolescents in the United States live with undiagnosed human immunodeficiency virus (HIV). Missed or delayed diagnoses adversely affect disease management and outcomes. This is particularly salient for patients receiving immunosuppressive and immunomodulatory therapy for the management of chronic inflammatory conditions, in which additional immunosuppression may increase...

Posted in: Infectious Disease123 Acquired Immunodeficiency Syndrome (AIDS) And Human Immunodeficiency Virus (HIV) Infection17

SMJ Article | Original Article

Opioid Use Disorder among Hospitalized Adults in North Carolina: Analysis from the 2000–2020 NC State Inpatient Database

Objectives: Opioid use disorder (OUD) is characterized as a chronic condition that was first outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and now the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision. It encompasses frequent opioid usage, cravings, the development of tolerance,...

SMJ Article | Review Article

Androgen Deprivation Therapy/Androgen Receptor Signaling Inhibitor Treatments for Prostate Cancer: Pathophysiology and Review of Effects on Cardiovascular Disease

Androgen deprivation therapy is the cornerstone of systemic management for prostate cancer but is associated with multiple adverse effects that must be considered during treatment. These effects occur because of the profound hypogonadism that is induced from lack of testosterone or due to the medications used in the treatment or...

Posted in: Prostate Disorders2

SMJ Article | Review Article

Common Comorbidities in Patients with Remitting Seronegative and Symmetrical Synovitis with Pitting Edema (RS3PE)

Objectives: Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) is considered a rare inflammatory rheumatologic disorder that is seen primarily in older adult men. Patients present with arthralgias of large joints accompanied by painful pitting edema of the hands and feet. Few studies have reported the prevalence of metabolic syndromes,...

Posted in: Rheumatology and Orthopedics19

SMJ Article | Original Article

Incidence Rates and Outcomes of Nodular and Superficial Spreading Melanoma along the Rural-Urban Continuum in Kentucky and Their Relationship to Provider Care Access

Objectives: This study compared incidence rates, stage at presentation, and cause-specific mortality of nodular and superficial spreading melanoma along the rural-urban continuum in Kentucky. We compared resulting patterns in our data with sample demographic and other potential factors, including population by county and primary care provider rate. Methods: Retrospective patient...

Posted in: Skin Cancer1

SMJ Article | Original Article

Eccentric Hamstring Strength Imbalance among Football and Soccer Athletes

Objectives: Hamstring strain injuries (HSI) are common among football and soccer athletes. Eccentric strength imbalance is considered a contributing factor for HSI. There is, however, a paucity of data on hamstring imbalances of soccer and American football athletes as they age and advance in skill level. High school athletes will...

SMJ Article | Review Article

Elevated Lp(a): Guidance for Identifying and Managing Patients

Key Points Elevated lipoprotein(a) (Lp(a)) is considered an independent and causal risk factor for atherosclerotic cardiovascular disease (ASVCD) and calcific aortic valve disease, affecting approximately 20% of individuals. Lp(a) levels are established in youth and are almost exclusively genetic and minimally affected by nonpharmacologic interventions. Clinicians should suspect elevated Lp(a)...

Posted in: Cardiovascular Disease23

SMJ Article | Perspectives

Know Your Guidelines Series: Diagnosis and Management of Nonalcoholic Fatty Liver Disease in Primary Care and Endocrinology Clinical Settings

Nonalcoholic fatty liver disease (NAFLD) represents a spectrum of liver disease without ongoing or significant alcohol use that ranges from hepatic steatosis to cirrhosis. NAFLD is associated with obesity, insulin resistance, type 2 diabetes mellitus (T2DM), hypertension, and dyslipidemia.1,2 Nonalcoholic steatohepatitis (NASH) represents the progression of NAFLD with at least...

Posted in: Endocrinology, Diabetes, and Metabolism16

SMJ Article | Original Article

Type 2 Diabetes Mellitus and Helicobacter pylori Eradication in a Clinical Population

Objectives: Eradication of Helicobacter pylori reduces the risk of gastric cancer (GC). Individuals with type 2 diabetes mellitus (T2DM) are known to be at increased risk for GC. In a cohort of H. pylori-positive individuals, we assessed whether those with T2DM were at risk of persistent infection following H. pylori...

Posted in: Endocrinology, Diabetes, and Metabolism16

SMJ Article | Perspectives

On the Tip of Our Tongue: Sublingual Cyclobenzaprine and Fibromyalgia

Fibromyalgia (FM) is a complex disease that affects 2% of the US population.1 The etiology and pathophysiology of FM are largely unknown2,3; however, genetic factors, infections, and physical or emotional events are known aggravating factors. Patients with FM typically report muscle pain and tenderness, most commonly in the upper mid-trapezius...

Posted in: Rheumatology and Orthopedics19

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