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

Painful Violaceous Purpura on a 44-Year-Old Woman

Returning to the fundamentals of our medical training, eliciting a full social history, including the use of illicit drugs, can be the key to making a correct diagnosis. This point is illustrated in the following case. A 44-year-old woman with a past medical history notable for asthma and heroin abuse, presented to the Emergency Department […]

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Appropriateness: A Key to Enabling the Use of Genomics in Clinical Practice?

President Obama’s Precision Medicine Initiative is poised to generate genome sequence data from 1 million Americans. However, such data are not yet routinely used in clinical care. It is time to formulate strategies for clinical decision making and policy around genomic information. We argue that appropriateness can help bridge the evidence gaps that have opened between patients’ genomes […]

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Multiple Chronic Conditions & Psychosocial Limitations in Patients Hospitalized with ACS

  As adults live longer, multiple chronic conditions have become more prevalent over the past several decades. We describe the prevalence of, and patient characteristics associated with, cardiac- and non-cardiac-related multimorbidities in patients discharged from the hospital after an acute coronary syndrome. Methods We studied 2174 patients discharged from the hospital after an acute coronary […]

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close up of gloved hands filling a syringe

Uptake of Influenza Vaccination and Missed Opportunities Among Adults

Since 1960, the Advisory Committee on Immunization Practices has recommended influenza vaccination for adults with certain high-risk conditions because of increased risk for complications from influenza infection. We assessed national influenza vaccination among persons ages 18-64 years with high-risk conditions. Methods We analyzed data from the 2012 and 2013 National Health Interview Survey. The Kaplan-Meier […]

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Triple vs Dual Antithrombotic Therapy in Patients with AF & CAD

Background The role of triple antithrombotic therapy vs dual antithrombotic therapy in patients with both atrial fibrillation and coronary artery disease remains unclear. This study explores the differences in treatment practices and outcomes between triple antithrombotic therapy and dual antithrombotic therapy in patients with atrial fibrillation and coronary artery disease. Methods Using the Outcomes Registry […]

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Warfarin and Vascular Calcification

  The vitamin K antagonist, warfarin, is the most commonly prescribed oral anticoagulant. Use of warfarin is associated with an increase in systemic calcification, including in the coronary and peripheral vasculature. This increase in vascular calcification is due to inhibition of the enzyme matrix gamma-carboxyglutamate Gla protein (MGP). MGP is a vitamin K-dependent protein that […]

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Radiation Effects on Cognitive Function Among Atomic Bomb Survivors Exposed at or After Adolescence

Background The objective of this study was to investigate radiation effects on longitudinal pre-dementia cognitive decline among participants who developed dementia as well as on those who did not develop dementia during follow-up. Methods Measuring cognitive function with the Cognitive Abilities Screening Instrument approximately every 2 years, we followed 1844 atomic bomb survivors participating in […]

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An Alternative Way to Provide Healthcare for Veterans

The Veterans Health Administration (VHA) has been under considerable scrutiny because of ongoing scandals; an independent evaluation found the VHA lacking. This article examined the cost impact of enrolling veterans (the 9.079 million who are currently enrolled in the VHA, the 6.633 million who use the VHA for care, or the 1.757 million VHA users […]

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