The American Journal of Medicine

Our medical research library holds 16 studies published in The American Journal of Medicine (1967–2019). Each entry links to the study's record on PubMed and, where there is one, to the publisher's page and a free full text. 11 have an abstract, the authors' own summary as PubMed records it: open "Abstract" to read it. For 2 studies PubMed has no abstract for, we give the abstract printed in the article or, where there is none, a summary we wrote from it, each labeled as such.

About the journal

• Publisher: Excerpta Medica
• Published: 1946 to the present, United States
• Language: English
• ISSN: 0002-9343 (print), 1555-7162 (electronic)
• Its record in the NLM Catalog

2010s

• Paraneoplastic Migratory Oligoarthritis in a Patient With Malignant Mesothelioma. M. Eidenschink, A. Beard, D. Ewart. 2019;132(11):e801-e802. Case report · Letter PubMed · Publisher

• Difficult to Identify: Malignant Primary Peritoneal Mesothelioma. B.S. Zha, M. Flanagan, C. Coulson, et al. 2015;128(11):1191-4. Case report PubMed · Publisher

  Summary

  This case report described a 59-year-old woman, a veteran and retired journalist who had never smoked. She presented with a 3-month history of abdominal pain, constipation and anorexia and a 40-pound (18.1 kg) weight loss. Ten years earlier she had undergone total hysterectomy with bilateral oophorectomy for endometriosis. Abdominal CT showed infiltrative opacities of the omentum, liver surface implants and a distended gallbladder, which raised concern for peritoneal carcinomatosis. Carbohydrate antigen 125 was elevated at 464 U/mL. Carcinoembryonic antigen and carbohydrate antigen 19-9 were normal. Attempts to obtain tissue failed. Ascites was scant, laparoscopy was advised against because of her low functional status, and a planned liver biopsy was not done after she became somnolent. She developed hypoxemic respiratory failure, was moved to comfort measures and died. Autopsy showed extensive tumor throughout the peritoneal cavity, with less involvement of the diaphragmatic pleura. Histology showed sarcomatoid high-grade cells with a smaller epithelioid component. The cells stained positive for calretinin, vimentin and pan-keratin, and rare cells stained for Wilms tumor-1 protein. No asbestos fibers were found. The diagnosis was primary malignant peritoneal mesothelioma. The authors noted that the causal role of asbestos in peritoneal mesothelioma in women is not clear. They concluded that patient histories should cover asbestos and other exposures, that the disease should be considered in patients with significant prolonged symptoms without a definitive diagnosis, and that laparoscopic biopsy is the gold standard for obtaining diagnostic tissue.

  PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

1990s

• The occupational history in the primary care setting. D.A. Schwartz, D.S. Wakefield, J.F. Fieselmann, et al. 1991;90(3):315-9. PubMed

  Abstract

  Purpose: To assess the need for services in occupational medicine, we determined the prevalence of reported occupational exposures in patients seen in the primary care setting. In addition, we evaluated the validity of our survey instrument.

  Patients And Methods: All patients (n = 1,112) seen over a 3-month period of time in the Primary Care Clinic at the Iowa City Veterans Affairs Medical Center were considered eligible for this study. A survey instrument was developed to obtain specific information regarding occupational exposures. The questionnaire was administered to 534 or 48% of all eligible patients. The validity of the survey instrument was evaluated by comparing chest radiographs in subjects with a history of exposure to asbestos, coal dust, or silica to those in patients who were not exposed to any of these agents.

  Results: We found that almost 75% of the patients reported prior occupational exposure to at least one potentially toxic agent, and over 30% claimed exposure to at least four potentially toxic agents. The validation study indicated that the reported exposure history for asbestos, coal dust, and silica is significantly associated with anticipated changes on chest radiographs. These findings suggest that this easily administered survey instrument is valid for pneumoconiotic dust exposures and may also be valid for other potentially toxic exposures.

  Conclusion: Data from our study indicate that patients seen in the ambulatory care setting may have clinically significant occupational exposures that are relevant to their medical condition.

1980s

• Pulmonary functional impairment from years of arc welding. K.H. Kilburn, R.H. Warshaw. 1989;87(1):62-9. PubMed · Publisher

  Abstract

  Purpose: The adverse effects of arc welding on pulmonary function have been previously documented. However, in many of these studies, the effects of welding exposure and smoking were not separated. Also, some studies did not adjust for or ignored the effects of asbestosis on pulmonary function. We assessed the long-term effects of welding on pulmonary function in welders who had no evidence of asbestosis on chest radiographs, and adjusted each individual value for height, age, and years of cigarette smoking.

  Patients And Methods: The study consisted of 226 male construction welders who had never worked in shipyards. Forced vital capacity (FVC) and flows were measured by spirometry, chest radiographs were obtained and examined for evidence of asbestosis using International Labor Office (ILO) criteria, and thoracic gas volume (TGV) was determined by planimetry. The subjects were also administered an occupational and respiratory questionnaire. Data on workers with asbestosis (ILO profusion 1/0 or greater) and pleural abnormalities were excluded. The mean age for the 226 subjects without asbestosis was 45 years, mean height was 175.7 cm, and mean duration of welding was 21.3 years. Pulmonary function measurements are presented as mean percentage of predicted (pop) and adjusted for height, age, and years of smoking.

  Results: In 151 current cigarette smokers, mean midflows and terminal flows were decreased, FEF25-75 to 93.2 pop and FEF75-85 to 91.2 pop, but FVC, forced expiratory volume in one second (FEV1) and TGV were normal. The 43 nonsmokers also had reductions in flows but normal FVC and TGV. Flows in both groups were significantly (p less than 0.05) below those of the referent group. The regression coefficient was -0.0031 for years of welding and FVC pop, -0.0035 for FEV1 pop, and -0.0080 for midflow pop (FEF25-75) (all significant at p less than 0.05), but the coefficient for FEF75-85 pop was not significant. As calculated from regression equations, 40 years of welding would reduce FVC to 95.2 pop, FEV1 to 92.2 pop, midflow to 79.2 pop, and FEF75-85 to 81.7 pop.

  Conclusion: Long-term exposure to welding gases and fumes reduced flows in small airways of welders without asbestosis.

• Interaction of asbestos, age, and cigarette smoking in producing radiographic evidence of diffuse pulmonary fibrosis. K.H. Kilburn, R. Lilis, H.A. Anderson, et al. 1986;80(3):377-81. PubMed · Publisher

  Abstract

  The study of 3,472 chest x-rays from four populations with different levels of exposure to asbestos and with different cigarette smoking histories shows that smoking in the general population does not produce pulmonary fibrosis recognizable on chest radiography. In the general population of Michigan, the prevalence of a radiographic pattern of fibrosis was 0.5 percent in men and 0.0 percent in women. In a Long Beach, California census tract population, the prevalences were 3.7 percent for men and 0.6 percent for women. Similarly, cigarette smoking does not enhance fibrosis when the exposure to asbestos has been as light as that in households of shipyard workers. Asbestosis was recognized in 6.6 percent of 137 shipyard workers' wives who have never smoked and 7.6 percent of 132 who had ever smoked. Cigarette smoking and asbestos appear to be synergistic in those occupationally exposed to asbestos (as insulators), since 7.2 percent of 97 nonsmokers and 20.5 percent of 316 ever-smokers showed fibrosis. This apparent synergy was also found in shipyard workers up to age 70 with 31 percent of nonsmokers and 43.3 percent of ever-smokers having fibrosis. There were increases of approximately 10 percent in the prevalence of fibrosis in cigarette smokers and nonsmokers for each decade after age 40.

• Malignant mesothelioma with brain metastases. J.A. Kaye, A.M. Wang, C.L. Joachim, et al. 1986;80(1):95-7. Case report PubMed · Publisher

  Abstract

  Although malignant mesothelioma is known to spread hematogenously, brain metastases are rare. In the patient presented herein, multiple unilateral symptomatic central nervous system metastases developed that were diagnosed by computed tomography and documented at autopsy. Since malignant mesothelioma is occurring more frequently in the population at risk (asbestos workers), this complication may be observed more commonly in the future.

• Pulmonary functional impairment and symptoms in women in the Los Angeles Harbor area. K.H. Kilburn, R. Warshaw, J.C. Thornton. 1985;79(1):23-8. PubMed · Publisher

  Abstract

  Spirometric measurements of vital capacity and flow rates, thoracic gas volume, and single-breath diffusing capacity for carbon monoxide were obtained in 360 white women, 238 wives age 58 years and 122 daughters age 32 years of shipyard workers from the Long Beach area of southern California. The values for nonsmokers, exsmokers, and current smokers were compared with smoking-specific mean values, age- and height-adjusted, from a reference population in Michigan. The wives from Long Beach had significantly lower mid and terminal flows, single-breath diffusing capacity for carbon monoxide, and alveolar volume, except that single-breath diffusing capacity for carbon monoxide was not significantly lower in current smokers. Nonsmokers and ex-smokers showed significantly different values for one-second forced expiratory volume in addition to flow rates and single-breath diffusing capacity for carbon monoxide. Daughters showed significant reductions in single-breath diffusing capacity for carbon monoxide and alveolar volume, which are attributable to maldistribution of inspired gas. These data showed that a powerful factor has affected expiratory air flow and distribution of gas, resulting in altered single-breath diffusing capacity for carbon monoxide and alveolar volume in this population. The factor is additive with and resembles the effect of cigarette smoking, and it is postulated that this factor is oxidant air pollution.

• Benign mesothelial proliferation with effusion. Clinicopathologic entity that may mimic malignancy. R.M. Hansen, J.G. Caya, L.J. Clowry, et al. 1984;77(5):887-92. Case report PubMed · Publisher

  Abstract

  The clinical and pathologic features of five cases of a previously poorly defined syndrome, benign mesothelial proliferation with effusion, are described. Although this is a benign process, both the gross and the microscopic findings may mimic metastatic papillary adenocarcinoma. Three of five patients had dysynchronous involvement in more than one body cavity developing over intervals of one, two, and six years. The clinical course is unpredictable and is usually associated with a good prognosis, but two of three patients with pericardial involvement required pericardectomy for pericardial tamponade. The entity of benign mesothelial proliferation with effusion and its distinction from true malignant conditions are discussed.

• Diagnostic utility of pleural fluid eosinophilia. M. Adelman, S.M. Albelda, J. Gottlieb, et al. 1984;77(5):915-20. PubMed · Publisher

  Abstract

  It has been stated that pleural fluid eosinophilia (defined as greater than 10 percent eosinophils in the pleural white cell differential count) is not helpful in the diagnosis of exudative effusions. By review of the recent literature, it was found that pleural fluid eosinophilia was associated most often with idiopathic effusions or with air previously introduced into the pleural space. Also, a high proportion of "idiopathic" and benign asbestos effusions were characterized by pleural fluid eosinophilia, a previously unrecognized phenomenon. The diagnostic utility of finding eosinophils in the pleural space was assessed from its impact on prior probabilities of disease. Estimates of pretest likelihoods of malignant versus nonmalignant pleural effusions and the prevalence of eosinophilia in effusions of known cause were obtained from extensive literature review. These were modified by using Bayes' rule to estimate the revised probability of disease in the presence of an eosinophilic effusion. The presence of pleural fluid eosinophilia considerably reduced the probability of malignancy or tuberculosis and increased the likelihood of an underlying benign disorder. Pleural fluid eosinophilia is a useful finding that can aid in the diagnosis of an exudative pleural effusion.

• Airway function in lifetime-nonsmoking older asbestos workers. R. Bégin, A. Cantin, Y. Berthiaume, et al. 1983;75(4):631-8. PubMed · Publisher

  Abstract

  Previous studies of lung function in asbestos workers have documented airflow limitation in many of the workers, but the specific influence of asbestos exposure could not be clearly differentiated from the effects of the cigarette smoking habit. In this study, airway function was evaluated in lifetime-nonsmoking, long-term workers of the mines and mills of Québec. The 17 asbestos workers in this study had worked for an average of 28 years in the mines and mills of the local asbestos industry and did not have any other respiratory industrial dust exposure. They did not have a history of previous pulmonary disease and did not meet the usual diagnostic criteria for chronic bronchitis, emphysema, or asthma. Seven of the workers met the diagnostic criteria for asbestosis and 10 workers did not. The latter group of workers did not differ from a matched control group except in terms of a higher isoflow volume (p less than 0.05). The workers with asbestosis, however, had a restrictive pattern of lung function, increased isoflow volume, and increased upstream resistance at low lung volumes (p less than 0.01). Lung biopsy in three of the patients with the disease demonstrated peribronchiolar alveolitis and fibrosis with obliteration and narrowing of the small airways. These data on lifetime-nonsmoking, long-term asbestos workers provide further evidence of small airway obstruction associated with asbestos exposure and independent of the smoking habit. This airflow limitation was observed predominantly in workers with a restrictive pattern of lung function associated with peribronchiolar alveolitis. The lifetime-nonsmoking asbestos workers without restrictive patterns of lung function had minimal dysfunction of the peripheral airways.

• Ventilatory failure due to asbestos pleurisy. A. Miller, A.S. Teirstein, I.J. Selikoff. 1983;75(6):911-9. Case report PubMed · Publisher

  Abstract

  Seven patients are described who had a distinctive syndrome of chest wall restriction caused by asbestos-induced pleural fibrosis. All had severe dyspnea and predominant pleural disease on radiographic examination, with pulmonary function findings of reduced vital capacity, total lung capacity (measured in five patients), and maximal voluntary ventilation. Five patients had ventilatory failure with carbon dioxide retention; four of these have died and one is close to death. Examination of the thoracic organs in five patients showed minimal or no parenchymal fibrosis in three and less severe involvement of the parenchyma than of the pleura in the remaining two. Neoplasms were suspected in three patients because of extension of the pleural fibrosis into the lung. Two of these patients had pleural uptake of 67-gallium citrate attributable to the inflammatory reaction. With the increasing duration since onset of exposure in the nine million workers who have been exposed to asbestos, as well as in other exposed persons, it is expected that additional cases of ventilatory failure caused by asbestos-induced pleural fibrosis will be encountered.

• Multimodality therapy for malignant mesothelioma based on a study of natural history. K.H. Antman, R.H. Blum, J.S. Greenberger, et al. 1980;68(3):356-62. PubMed · Publisher

1970s

• Asbestos-associated neoplasms of B cell lineage. E. Kagan, R.J. Jacobson, K.Y. Yeung, et al. 1979;67(2):325-30. Case report PubMed · Publisher

  Abstract

  Three different neoplasms of B cell lineage, chronic lymphocytic leukemia, immunoglobulin A (IgA) myeloma and immunoglobulin G (IgG) myeloma were detected in three patients who had heavy occupational exposure to asbestos dust. Two of the patients had coexistent pulmonary asbestosis, whereas the third patient had a pleural mesothelioma subsequent to his initial presentation with myeloma. Defective cell-mediated immunity and hyperactivity of B cell function have previously been noted in patients with asbestosis. We suggest the possibility that these asbestos-related immunologic derangements may predispose to the development of immunoproliferative and lymphoproliferative neoplasms, since such tumors have been observed in a variety of other settings, characterized by protracted hyperactivity of the immune system.

• Fever, hepatic lesions and ascites. 1979;67(1):105-12. Case report PubMed · Publisher

• Asbestos exposure and related neoplasia. The 28 year experience of a major urban hospital. F.M. Hasan, G. Nash, H. Kazemi. 1978;65(4):649-54. PubMed · Publisher

  Abstract

  In a retrospective study of 49 cases of asbestosis, a steady increase in the frequency of diagnosis of asbestosis and asbestos-related neoplasia is documented from a major urban hospital since 1960. Although in the majority of cases the subjects were exposed to asbestos in a neighboring shipyard, in 20 per cent of the cases, asbestos exposure was in industries not related to shipbuilding, reflecting its widespread use. This selective population of patients with asbestosis more often than not had an associated neoplasm. The most likely accompanying tumor was pleural mesothelioma, and among cell types of lung cancer, adenocarcinoma was notably frequent.

1960s

• Asbestosis and neoplasia. I.J. Selikoff, R.A. Bader, M.E. Bader, et al. 1967;42(4):487-96. Review PubMed · Publisher

  Summary

  This editorial addressed a prediction by Thomson that asbestos-induced neoplasms would rival cigarette-induced lung cancer. It noted that asbestos bodies were found in the lungs of at least one fourth of adults dying in urban areas. The authors reviewed published evidence and their own data, emphasizing the long latent period of asbestos disease. Among 1,117 asbestos insulation workers, chest X-ray abnormalities were found in 10.4% of those first exposed less than ten years before, 44.1% at 10-19 years, 72.8% at 20-29 years, and over 90% after more than thirty years. Among 56 consecutive patients with neoplasm of the lung or pleura, death from lung cancer did not occur less than twenty years after onset of exposure. Of 325 consecutive deaths among insulation workers (1943-1966), 17 (about 5%) were due to mesothelioma, against about 1 in 10,000 deaths in the general population. In Dresden, lung cancer deaths rose as deaths from severe asbestosis fell with improved industrial hygiene. Pleural calcification was rare within twenty years of first exposure (5 of 725 workers) but was present in more than half of workers after forty years. Stomach and colon cancers also appeared increased. The authors stressed that disease could progress after exposure ended and urged occupational histories covering work decades earlier. They projected that neoplasms from current asbestos use would not appear until the 1990s, and they called for better industrial hygiene and awareness of environmental contamination.

  PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

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