American Journal of Medicine, internal medicine, medicine, health, healthy lifestyles, cancer, heart disease, drugs

The Frequency of Unnecessary Testing in Hospitalized Patients

Testing is an important part of medicine across all specialties and settings. As a result, the volume of testing is enormous, with an estimated 4-5 billion tests performed in the United States each year.1 Unnecessary laboratory testing and diagnostic imaging is believed to be common. Studies looking at testing of patients have found 40%-60% of tests […]

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Different Causes of Death in Patients with Myocardial Infarction Type 1, Type 2, and Myocardial Injury

Data outlining the mortality and the causes of death in patients with type 1 myocardial infarction, type 2 myocardial infarction, and those with myocardial injury are limited. Methods During a 1-year period from January 2010 to January 2011, all hospitalized patients who had cardiac troponin I measured on clinical indication were prospectively studied. Patients with […]

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vegetable juices and veggies on a table

How Pure is PURE? Dietary Lessons Learned and Not Learned From the PURE Trials

The Prospective Urban Rural Epidemiology (PURE) cohort studies add a new level of understanding of some key environmental components of health.1 The population is diverse, and represents individuals from various socioeconomic levels with a long period of follow-up. The dietary macronutrient analysis of this cohort conducted by the study group2 has yielded interesting findings, undoubtedly warranting additional […]

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Unusual Case of Fever and Abdominal Pain

Pyogenic liver abscess is an uncommon type of intra-abdominal abscess and occurs in approximately 3.6 per 100,000 hospitalized individuals.1 The incidence of pyogenic liver abscess is increasing.1 Here we present a case of Streptococcus anginosus liver abscess, secondary to acute uncomplicated sigmoid diverticulitis and acute cholecystitis. Case Report A 63-year-old man presented to our tertiary medical center with a […]

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Social Determinants of Treatment Response

Socioeconomic status is consistently linked to population health and specifically to the finding that there is decreasing health associated with decreasing social position. Despite the substantial literature, an analogous literature that is focused on clinical practice, and especially consideration of the individual, is almost nonexistent. Even in the absence of these data, physicians routinely incorporate […]

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Colonic Anisakiasis

To the Editor: A 24-year-old man with a 2-week history of nausea, lower-right abdominal pain, and melena presented to the Gastroenterology outpatient clinic. He had no previous cardiovascular or gastrointestinal problems and denied any history of an allergy. In addition, the patient reported having eaten raw mackerel, sardines, and squid at a sushi restaurant 2 […]

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Scurvy, a Not-So-Ancient Disease

A 65-year-old man with a history of alcohol and tobacco use and few medical interactions presented with 1 week of progressive dyspnea. Examination revealed a cachectic man with large areas of nonpainful ecchymoses on the posterior thighs (Figure). Additional skin findings included spider angiomata on the face and chest, scattered bruising on upper extremities, and […]

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Multiple Sclerosis Re-Examined: Essential and Emerging Clinical Concepts

Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system characterized by exacerbations of neurological dysfunction due to inflammatory demyelination. Neurologic symptoms typically present in young adulthood and vary based on the site of inflammation, although weakness, sensory impairment, brainstem dysfunction, and vision loss are common. MS occurs more frequently in women […]

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