Eric Matheson | Medical University of South Carolina (original) (raw)

Papers by Eric Matheson

PubMed, Aug 1, 2019

Hirsutism is the excessive growth of terminal hair in a typical male pattern in a female. It is o... more Hirsutism is the excessive growth of terminal hair in a typical male pattern in a female. It is often a sign of excessive androgen levels. Although many conditions can lead to hirsutism, polycystic ovary syndrome and idiopathic hyperandrogenism account for more than 85% of cases. Less common causes include idiopathic hirsutism, nonclassic congenital adrenal hyperplasia, androgen-secreting tumors, medications, hyperprolactinemia, thyroid disorders, and Cushing syndrome. Women with an abnormal hirsutism score based on the Ferriman-Gallwey scoring system should be evaluated for elevated androgen levels. Women with rapid onset of hirsutism over a few months or signs of virilization are at high risk of having an androgen-secreting tumor. Hirsutism may be treated with pharmacologic agents and/or hair removal. Recommended pharmacologic therapies include combined oral contraceptives, finasteride, spironolactone, and topical eflornithine. Because of the length of the hair growth cycle, therapies should be tried for at least six months before switching treatments. Hair removal methods such as shaving, waxing, and plucking may be effective, but their effects are temporary. Photoepilation and electrolysis are somewhat effective for long-term hair removal but are expensive.

PubMed, 2023

Temporomandibular disorders affect between 5% and 12% of the population and present with symptoms... more Temporomandibular disorders affect between 5% and 12% of the population and present with symptoms such as headache, bruxism, pain at the temporomandibular joint, jaw popping or clicking, neck pain, tinnitus, dizziness, decreased hearing, and hyperacuity to sound. Common signs on physical examination include tenderness of the pterygoid muscles, temporomandibular joints, and temporalis muscles, and malocclusion of the jaw and crepitus. The diagnosis is based on history and physical examination; however, use of computed tomography or magnetic resonance imaging is recommended if the diagnosis is in doubt. Nonpharmacologic therapy includes patient education (e.g., good sleep hygiene, soft food diet), cognitive behavior therapy, and physical therapy. Pharmacologic therapy includes nonsteroidal anti-inflammatory drugs, cyclobenzaprine, tricyclic antidepressants, and gabapentin. Injections of the temporomandibular joints with sodium hyaluronate, platelet-rich plasma, and dextrose prolotherapy may be considered, but the evidence of benefit is weak. A referral to oral and maxillofacial surgery is indicated for refractory cases.

American Family Physician, Oct 1, 2021

Diabetes-related foot infections occur in approximately 40% of diabetes-related foot ulcers and c... more Diabetes-related foot infections occur in approximately 40% of diabetes-related foot ulcers and cause significant morbidity. Clinicians should consider patient risk factors (e.g., presence of foot ulcers greater than 2 cm, uncontrolled diabetes mellitus, poor vascular perfusion, comorbid illness) when evaluating for a foot infection or osteomyelitis. Indicators of infection include erythema, induration, tenderness, warmth, and drainage. Superficial wound cultures should be avoided because of the high rate of contaminants. Deep cultures obtained through aseptic procedures (e.g., incision and drainage, debridement, bone culture) help guide treatment. Plain radiography is used for initial imaging if osteomyelitis is suspected; however, magnetic resonance imaging or computed tomography may help if radiography is inconclusive, the extent of infection is unknown, or if the infection orientation needs to be determined to help in surgical planning. Staphylococcus aureus and Streptococcus agalactiae are the most commonly isolated pathogens, although polymicrobial infections are common. Antibiotic therapy should cover commonly isolated organisms and reflect local resistance patterns, patient preference, and the severity of the foot infection. Mild and some moderate infections may be treated with oral antibiotics. Severe infections require intravenous antibiotics. Treatment duration is typically one to two weeks and is longer for slowly resolving infections or osteomyelitis. Severe or persistent infections may require surgery and specialized team-based wound care. Although widely recommended, there is little evidence on the effectiveness of primary prevention strategies. Systematic assessment, counseling, and comorbidity management are hallmarks of effective secondary prevention for diabetes-related foot infections.

Clinical Nutrition, 2021

Background & aims: The world's over-65 population is expanding rapidly, and the risk of malnutrit... more Background & aims: The world's over-65 population is expanding rapidly, and the risk of malnutrition is prevalent in this population. Meeting nutritional needs is a recognized strategy to reduce and address multiple debilitating adverse health outcomes associated with malnutrition. The objective of this randomized, controlled trial was to determine the effects of oral nutritional supplement (ONS) containing beta-hydroxy-beta-methylbutyrate (HMB), along with dietary counseling, on health outcomes in community-dwelling older adults at risk of malnutrition. Methods: Strengthening Health In ELDerly through nutrition (SHIELD) studied adults aged 65 years in Singapore who were recruited between August 2017 and March 2019. Participants were community ambulant and classified as medium or high risk for malnutrition using Malnutrition Universal Screening Tool (MUST). Participants (n ¼ 811) were randomly assigned to one of two study treatments for 180 days: (i) two servings/day of ONS containing HMB with dietary counseling (n ¼ 405) or (ii) two servings/day of placebo supplement with dietary counseling (n ¼ 406). The primary composite outcome was 'survival without hospital (re)admission and with at least 5% weight gain to day 180'. Dietary intakes, nutritional and functional outcomes were measured at baseline, 30, 90, and 180 days. Results: A higher proportion in intervention group met the 180-day primary composite outcome compared to placebo (33.4% vs. 8.7%, P < 0.001), largely driven by body weight component (36.2% vs. 9.4%, P < 0.001). Survival and hospital (re)admission rate were not significantly different between the groups. Weight, BMI, and mid upper arm circumference were significantly greater in the intervention group compared to placebo during the study (all P < 0.001), and at days 30, 90, and 180 (all P < 0.05). The odds of having better nutritional status during the study were also significantly higher in the intervention group compared to placebo, as measured using MUST risk (OR ¼ 2.68, P < 0.001

Journal of the American Board of Family Medicine, Nov 1, 2009

Background: A history of atopic respiratory conditions has been linked to an increased risk of st... more Background: A history of atopic respiratory conditions has been linked to an increased risk of stroke. What remains unclear is whether positive allergy skin testing is associated with an increased risk of stroke. The primary goal of this study was to determine whether positive allergy skin testing is associated with an increased risk of fatal stroke. A secondary goal is to determine whether having both positive allergy skin testing and an atopic respiratory condition is associated with a particularly high risk of stroke death. Methods: An analysis was performed of the National Health and Nutrition Examination Survey II Mortality Cohort. Results: Controlling for age, gender, race, alcohol use, smoking status, diabetes, hypertension, and body mass index, patients with positive allergy skin testing had a hazard ratio for stroke mortality of 1.56 (95% CI, 1.01-2.40) versus those without positive allergy testing. Patients with both positive allergy testing and an atopic respiratory condition had a hazard ratio for stroke mortality of 2.31 (95% CI, 1.13-4.73). Conclusions: Individuals with both positive allergy skin testing and an atopic respiratory condition have more than a 2-fold increased risk of fatal stroke. This novel risk factor has substantial implications for a large segment of the population not previously considered at risk. (J Am Board Fam Med 2009;22:604-609.) Stroke is the third leading cause of mortality in the United States, accounting for more than 150,000 deaths in 2004. 1,2 This number is expected to rise significantly as the population of the United States ages. Progress has been made in identifying the risk factors that are responsible for stroke, but our understanding remains incomplete. Even the most complex multivariate models including major risk factors such as smoking and diabetes as well as more minor risk factors fail to fully predict who is at risk for stroke. 3 This article was externally peer reviewed.

Religiosity has been associated with decreased mortality rates [1]. Approximately 83% of American... more Religiosity has been associated with decreased mortality rates [1]. Approximately 83% of Americans self-identified with some form of organized religion in 2013 and almost 60% reported membership in a church or synagogue [2]. While there has been some shifting of denomination allegiance as well as decrease in the frequency of weekly church attendance, it still seems that a large portion of the US population considers itself religious [1,3].

Clinical Nutrition, 2021

Background: Hospitalized, malnourished older adults with chronic obstructive pulmonary disease (C... more Background: Hospitalized, malnourished older adults with chronic obstructive pulmonary disease (COPD) have an elevated risk of readmission and mortality. Objective: Post-hoc, subgroup analysis from the NOURISH study cohort examined the effect of a highprotein oral nutritional supplement (ONS) containing HMB (HP-HMB) in malnourished, hospitalized older adults with COPD and to identify predictors of outcomes. Methods: The NOURISH study (n ¼ 652) was a multicenter, randomized, placebo-controlled, doubleblind trial. The COPD subgroup (n ¼ 214) included hospitalized, malnourished (based on Subjective Global Assessment), older adults (!65 y), with admission diagnosis of COPD who received either standard-of-care plus HP-HMB (n ¼ 109) or standard-of-care and a placebo supplement (n ¼ 105) prescribed 2 servings/day from within 3 days of hospital admission (baseline) and up to 90 days after discharge. The primary study outcome was a composite endpoint of incidence of death or non-elective readmission up to 90-day post-discharge, while secondary endpoints included changes in hand-grip strength, body weight, and nutritional biomarkers over time. Categorical outcomes were analyzed using Cochran-Mantel-Haenszel tests, longitudinal data by repeated measures analysis of covariance; and changes from baseline by analysis of covariance. p-values 0.05 were considered statistically significant. Multivariate logistic regression was used to model predictors of the primary outcome and components. Results: In patients with COPD, 30, 60, and 90-day hospital readmission rate did not differ, but in contrast, 30, 60, and 90-day mortality risk was approximately 71% lower with HP-HMB supplementation relative to placebo (1.83%, 2.75%, 2.75% vs. 6.67%, 9.52% and 10.48%, p ¼ 0.0395, 0.0193, 0.0113, resp.). In patients with COPD, compared to placebo, intake of HP-HMB resulted in a significant increase in handgrip strength (þ1.56 kg vs. À0.34 kg, p ¼ 0.0413) from discharge to day 30; increased body weight from baseline to hospital discharge (0.66 kg vs. À0.01 kg, p < 0.05) and, improvements in blood nutritional biomarker concentrations. The multivariate logistic regression predictors of the death, readmission or composite endpoints in these COPD patients showed that participants who were severely malnourished (p ¼ 0.0191) and had a Glasgow prognostic score (GPS) Score of 1 or 2 had statistically significant odds of readmission or death (p ¼ 0.0227). Conclusions: Among malnourished, hospitalized patients with COPD, supplementation with HP-HMB was associated with a markedly decreased mortality risk, and improved handgrip strength, body weight, and nutritional biomarkers within a 90-day period after hospital discharge. This post-hoc, subgroup analysis highlights the importance of early identification of nutritional risk and

Menopause, 2009

The aim of this study was to determine whether frequent onion consumption is associated with incr... more The aim of this study was to determine whether frequent onion consumption is associated with increased bone density in perimenopausal and postmenopausal non-Hispanic white women 50 years and older. An analysis of the National Health and Nutrition Examination Survey 2003-2004 was performed. Perimenopausal and postmenopausal non-Hispanic white female participants (unweighted N = 507; weighted N = 35.7 million) were divided into those who consumed onions less than once a month, twice a month to twice a week, three to six times a week, and once a day or more based on self-reported dietary history. All study participants underwent total body dual-energy x-ray absorptiometry. After controlling for age, body mass index, daily calcium intake, serum vitamin D, serum parathyroid hormone, estrogen use, smoking status, and exercise status, bone density increased as the frequency of onion consumption increased. Individuals who consumed onions once a day or more had an overall bone density that was 5% greater than individuals who consumed onions once a month or less (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.03). Onion consumption seems to have a beneficial effect on bone density in perimenopausal and postmenopausal non-Hispanic white women 50 years and older. Furthermore, older women who consume onions most frequently may decrease their risk of hip fracture by more than 20% versus those who never consume onions.

American family physician, 2021

Journal of the American Dietetic Association, 2009

A high-cholesterol diet has been associated with an increased risk of coronary heart disease, but... more A high-cholesterol diet has been associated with an increased risk of coronary heart disease, but it is unclear whether all high-cholesterol foods increase the risk of heart disease. The purpose of this study is to determine whether shellfish consumption is associated with an increased risk of coronary heart disease. Analysis was performed on the Atherosclerosis Risk in Communities study, a cohort of middle aged and elderly adults in the United States. The association between reported shellfish consumption to the development of coronary heart disease was examined. The cohort was divided into low, medium, and high shellfish consumers. There were 13,355 participants meeting our inclusion criteria, of which 1,382 suffered a coronary heart disease event. Using low shellfish consumers as the reference group, the medium shellfish consumers had an unadjusted hazard ratio of 0.89 (95% confidence interval [CI] 0.79 to 1.00), and the high shellfish consumers had an unadjusted hazard ratio of 0.91 (95% CI 0.80 to 1.03) of suffering a coronary heart disease event. In a model that was adjusted for age, sex, race, smoking status, body mass index, diabetes, hypertension, low-density lipoprotein cholesterol level, high-density lipoprotein cholesterol level, family history of early heart disease, and exercise status using the low shellfish consumers as the reference group, medium shellfish consumers had a hazard ratio of 0.96 (95% CI 0.80 to 1.16), and the high shellfish consumers had a hazard ratio of 0.98 (95% CI 0.82 to 1.18) of experiencing a coronary heart disease event.

American Family Physician, Jul 1, 2017

Insomnia accounts for more than 5.5 million visits to family physicians each year. Although behav... more Insomnia accounts for more than 5.5 million visits to family physicians each year. Although behavioral interventions are the mainstay of treatment, pharmacologic therapy may be necessary for some patients. Understanding the risks and benefits of insomnia medications is critical. Controlled-release melatonin and doxepin are recommended as first-line agents in older adults; the so-called z-drugs (zolpidem, eszopiclone, and zaleplon) should be reserved for use if the first-line agents are ineffective. For the general population with difficulty falling asleep, controlled-release melatonin and the z-drugs can be considered. For those who have difficulty staying asleep, low-dose doxepin and the z-drugs should be considered. Benzodiazepines are not recommended because of their high abuse potential and the availability of better alternatives. Although the orexin receptor antagonist suvorexant appears to be relatively effective, it is no more effective than the z-drugs and much more expensiv...

Infective endocarditis (IE) is an important cause of morbidity and mortality, and the incidence o... more Infective endocarditis (IE) is an important cause of morbidity and mortality, and the incidence of this disease among the elderly, recipients of prosthetic valves, and intravenous drug abusers has been increasing. The emergence of microbial resistance has complicated treatment of this disease. Primary prevention, early disease recognition, and prompt treatment are vital in reducing the incidence of IE as well

American family physician, 2014

Gout is characterized by painful joint inflammation, most commonly in the first metatarsophalange... more Gout is characterized by painful joint inflammation, most commonly in the first metatarsophalangeal joint, resulting from precipitation of monosodium urate crystals in a joint space. Gout is typically diagnosed using clinical criteria from the American College of Rheumatology. Diagnosis may be confirmed by identification of monosodium urate crystals in synovial fluid of the affected joint. Acute gout may be treated with nonsteroidal anti-inflammatory drugs, corticosteroids, or colchicine. To reduce the likelihood of recurrent flares, patients should limit their consumption of certain purine-rich foods (e.g., organ meats, shellfish) and avoid alcoholic drinks (especially beer) and beverages sweetened with high-fructose corn syrup. Consumption of vegetables and low-fat or nonfat dairy products should be encouraged. The use of loop and thiazide diuretics can increase uric acid levels, whereas the use of the angiotensin receptor blocker losartan increases urinary excretion of uric acid....

American family physician, 2019

Nutrients

Malnutrition is a common yet under-recognized problem in hospitalized patients. The aim of this p... more Malnutrition is a common yet under-recognized problem in hospitalized patients. The aim of this paper was to systematically review and evaluate malnutrition biomarkers among order adults. Eligible studies were identified through Cochrane, PubMed and the ProQuest Dialog. A meta-regression was performed on concentrations of biomarkers according to malnutrition risks classified by validated nutrition assessment tools. A total of 111 studies were included, representing 52,911 participants (55% female, 72 ± 17 years old) from various clinical settings (hospital, community, care homes). The estimated BMI (p < 0.001) and concentrations of albumin (p < 0.001), hemoglobin (p < 0.001), total cholesterol (p < 0.001), prealbumin (p < 0.001) and total protein (p < 0.05) among subjects at high malnutrition risk by MNA were significantly lower than those without a risk. Similar results were observed for malnutrition identified by SGA and NRS-2002. A sensitivity analysis by including patients with acute illness showed that albumin and prealbumin concentrations were dramatically reduced, indicating that they must be carefully interpreted in acute care settings. This review showed that BMI, hemoglobin, and total cholesterol are useful biomarkers of malnutrition in older adults. The reference ranges and cutoffs may need to be updated to avoid underdiagnosis of malnutrition.

PubMed, Aug 1, 2019

PubMed, 2023

American Family Physician, Oct 1, 2021

Clinical Nutrition, 2021

Journal of the American Board of Family Medicine, Nov 1, 2009

Clinical Nutrition, 2021

Menopause, 2009

American family physician, 2021

Journal of the American Dietetic Association, 2009

American Family Physician, Jul 1, 2017

American family physician, 2014

American family physician, 2019

Nutrients