Phenibut

Phenibut: Buyer Beware

Phenibut, the Appearance of Another Potentially Dangerous Product in the United States Since the advent of the Internet, many quasi-legal substances with significant toxicity and abuse potential have found their way into the hands of consumers across the US. In recent years, multiple reports of abuse and withdrawal syndromes related to Internet-purchased synthetic cannabinoids and […]

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Caffeine & Exercise

Caffeine Reduces Myocardial Blood Flow During Exercise Caffeine (1,3,7-trimethylxanthine) is one of the most widely used pharmacologically active drugs in the world and is found in products such as colas, coffee, tea, energy beverages, dietary supplements, over-the-counter medications, and chocolate. It has been estimated that worldwide caffeine consumption is approximately 76 mg/d per person; in […]

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hand

Into Thin Air: Shrinking Lung Syndrome

When chest percussion revealed diminished lung volumes in a 52-year-old African American woman, her diagnostic possibilities expanded. The patient, hospitalized with fever, progressive dyspnea, and diffuse joint pain, felt well until 11 months earlier. At that time, she began a course of peginterferon alfa-2, ribavirin, and boceprevir for hepatitis C acquired from a blood transfusion. Five […]

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Joseph S. Alpert, MD

Despite Advances, DVT Rates Remain High (video)

Despite advances in identification, prophylaxis, and treatment between 1985 and 2009, the annual event rate of venous thromboembolism has increased and remains high. Read new research in the October 2014 issue of The American Journal of Medicine.

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Trends in Stroke Rates, Risk, and Outcomes

Trends in Stroke Rates, Risk, and Outcomes in the United States, 1988 to 2008 Background Stroke is a major cause of morbidity and mortality. We describe trends in the incidence, outcomes, and risk factors for stroke in the US Medicare population from 1988 to 2008. Methods We analyzed data from a 20% sample of hospitalized Medicare […]

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Predictive Parameters of Accelerated Muscle Loss in Men—MINOS Study

Background Aging-related muscle loss is a public health problem. We investigated the association of lifestyle and hormonal factors with a prospectively assessed muscle loss in older men. Methods Among 608 home-dwelling men, aged 60-85 (mean 68) years, lifestyle and health status were evaluated through a questionnaire. Appendicular skeletal muscle mass was estimated using dual-energy x-ray […]

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The Onion

AJM ‘Research’ Featured in The Onion

Is imitation the sincerest form of flattery? If so, The Onion paid a compliment to The American Journal of Medicine in August. A satirical Onion post cites a fictitious research study warning people not to spend too much time together. From The Onion… A study published Thursday in The American Journal Of Medicine determined that it is highly detrimental […]

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Drug-induced Dilemma

Drug-induced Dilemma: Angiokeratomas and Decreased Renal Function   Timing is everything, according to the well-worn aphorism. Yet, it certainly proved true when a diagnosis was sought for a puzzling set of signs and symptoms. An 84-year-old woman was referred to our hospital in December 2012, due to the sudden appearance of multiple eruptive hemorrhagic papules […]

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Cardiac Rehabilitation, Readmissions, and Death After Acute MI

Background Participation in cardiac rehabilitation has been shown to decrease mortality after acute myocardial infarction, but its impact on readmissions requires examination. Methods We conducted a population-based surveillance study of residents discharged from the hospital after their first-ever myocardial infarction in Olmsted County, Minnesota, from January 1, 1987, to September 30, 2010. Patients were followed […]

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‘Real-World’ Antithrombotic Treatment in AF

‘Real-World’ Antithrombotic Treatment in Atrial Fibrillation: The EORP-AF Pilot Survey   Background Current guidelines strongly recommend that oral anticoagulation should be offered to patients with atrial fibrillation and ≥1 stroke risk factors. The guidelines also recommend that oral anticoagulation still should be used in the presence of stroke risk factors irrespective of rate or rhythm […]

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Joseph S. Alpert, MD

New Critical Review: Decreased Risk for Heart Disease (video)

Primary and secondary prevention has decreased the incidence of acute myocardial infarction and sudden cardiac deaths from the mid- 1960s to the present. Check out this article in the September 2014 issue of The American Journal of Medicine.

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Fatality Risks on the Road and in Space

On February 1, 2013, millions of Americans commemorated the 10-year anniversary of the loss of Space Shuttle Columbia and its 7-member crew. Much less visible, however, was the 10-year anniversary of the 122 automobile crash deaths that also occurred in the United States on February 1, 2003.1 Space travel and road travel do not pose competing risks and […]

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Venous Gangrene

Venous Gangrene and Intravascular Coagulation and Fibrinolysis in a Patient Treated with Rivaroxaban A 67-year-old woman presented with new bilateral leg swelling and was diagnosed with bilateral deep vein thromboses. Rivaroxaban was started at 15 mg twice daily. Ten days later, the patient experienced increased right foot swelling, pain, and cyanosis (Figure). On admission, a right […]

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The Consumption Gene

After years of pondering the over-testing, over-imaging, over-diagnosis, and over-treatment that typify US medicine, I have concluded that, like everything else, it must be genetic: We have evolved a gene that controls (or rather, disinhibits) consumption in all its forms. Although the gene has yet to be identified, I think it should be designated as […]

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