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

Sudden Creatine Kinase Elevation When an Athlete Starts Boxing: Looking Deeper Prior to Knocking the Statin Out

A 55-year-old Caucasian man with a prior computed tomography calcium score in the 75th percentile for age, sex, and race at age 39 years, and on long-term high-intensity statin therapy presented with episodic myalgia. He reported 3 episodes within the past year of sudden severe quadriceps pain that self-resolved within 2 days. His activities included biking […]

Read more

House Calls

When I was a medical student, 50 years ago, physicians, especially pediatricians, internists, and family physicians, were still making house calls as part of their provision of care for their patients.1 The symbol of the practicing physician at that time was the “black bag,” which contained diagnostic tools like the stethoscope, ophthalmoscope, tuning fork, reflex hammer, […]

Read more

Acute Epigastric Pain as the Cause of Urgent Gastrectomy in a Healthy Patient

A 63-year-old man with no surgical history, taking no medication,was referred to the emergency department for epigastric pain and nausea that had started afew hours earlier. A sore throat had begun 24hours previously. Physical examination revealed normal temperature, hemodynamic stability, a distended abdomen with abdominal guarding that was very painful on palpation, and no mass […]

Read more

Unusual Cause of Persistent Cough: ‘Pill Aspiration’

A 57-year-old woman with carcinoid syndrome was referred to the pulmonary clinic by her primary care physician (PCP) for persistent cough for the past 6 weeks. She was evaluated by her PCP approximately 6 weeks earlier for cough, which the patient thought started after she had aspirated one of her medications. Results from initial clinical […]

Read more

Medical Axioms: The Pithy Little Sayings That Reflect Deeper Knowledge

  I love axioms. Perhaps it is the result of hearing them from one of my earliest mentors in medical school. Or perhaps it is the result of advice given me by my journalist/English teacher mother who told me that everything you write can be improved by condensation. Whatever the underlying reason, I continue to […]

Read more

Social Media and Physician Conflict of Interest

The use of social media by physicians has increased substantially in recent years, with some estimates reporting increases from 41.6% in 2010 to as high as 90% in 2011.1 While personal use is more common, approximately 65% of physicians interact with various social media platforms for professional reasons.1 For example, some physicians use social media to promote […]

Read more
doctor gives a physical examination of a patient

Reducing Hospital Toxicity: Impact on Patient Outcomes

Circadian rhythms are endogenous 24-hour oscillations in biologic processes that drive nearly all physiologic and behavioral functions. Disruption in circadian rhythms can adversely impact short- and long-term health outcomes. Routine hospital care often causes significant disruption in sleep-wake patterns that is further compounded by loss of personal control of health information and health decisions. We […]

Read more

Ethico-Legal Challenges of Drug Packing—A Case Report

Body-packing, or the internal concealment of illicit drugs, has been described worldwide and is typically used to smuggle drugs across secure borders. Body-packers who swallow or insert packets of illicit drugs into body cavities are at risk for acute toxicity and gastrointestinal obstruction. We present a case of body-packing that exposed the challenging ethical and […]

Read more

Work–Life Balance, Burnout, and the Electronic Health Record

United States physicians were studied by Shanafelt et al in 2011, and again in 2014, regarding burnout and satisfaction with work–life balance.1 Physician burnout increased significantly, from 45.5% to 54.4%. Parallel studies of all US workers during the same period showed no changes. There are several possible explanations for this. New physician members were added to the […]

Read more

At the Root: Cutaneous Langerhans Cell Histiocytosis

Hair loss is of deep concern to patients, mainly because of its effect on appearance. On rare occasions, however, areas of balding can signal malignancy. A 33-year-old woman was referred to our dermatology clinic because of a 15-year history of scalp eruption accompanied by intense itching and progressive hair loss. Previously, she was diagnosed with […]

Read more
UA-42320404-1