American Journal of Medicine, internal medicine, medicine, health, healthy lifestyles, cancer, heart disease, drugs
white tablets spilling out of a pill bottle

Managing Increasing Liability Risks Related to Opioid Prescribing

The increase in prescription opioid-related overdose deaths has increasingly led to liability and sanctions for physicians. For instance, in January 2010, Maurice Conte, MD was found negligent for prescribing a combination of Vicodin, Xanax, and Soma, which caused an overdose death, and was fined over $9 million.1 Conte, as the Medical Director of pain clinics, rarely […]

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doctor on laptop medical graphics floating in the air

Best Practice Advisories Should Not Replace Good Clinical Acumen

Electronic medical records (EMR) have revolutionized clinical practice. They facilitate documentation, improve communication and coordination of care among medical providers, and afford a manner of communication for patients, as well as provide a platform for the storage of large quantities of clinical data. Several of these qualities, in addition to federal incentives for their use, […]

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A Red Herring in the Green Grass: Syphilitic Membranous Glomerulonephritis

Physical discomfort attributed to a routine chore was actually an unusual presentation of an insidious infection. A 51-year-old man presented to the emergency department and reported 1 week of persistent, localized lower back pain that began after he had spent the day mowing his lawn. He denied any trauma, rash, dysuria, discoloration of urine, or […]

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Joseph S. Alpert

Digital Medicine: “O Brave New World”

Recently, I participated in an international meeting in Nanjing, China on digital medicine. The meeting was sponsored by the Chinese Society of Digital Medicine and the newly formed International Society of Digital Medicine, both under the leadership of the remarkably energetic and effective professor, Shaoxiang Zhang from Chongqing, China. For my part of the meeting, […]

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Deadly Diarrhea: The Clever Disguise of Aortic Dissection

  Aortic dissection is one of the great imitators that can present in many ways clinically, depending on the portion of the aorta undergoing dissection.1 Therefore, it is of utmost importance to discuss the variety of presentations, including those that are rare, so as not to miss this potentially fatal diagnosis. Our case is important because […]

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A Hard Calculus: Submandibular Sialolithiasis

  Eating worsened the discomfort a 52-year-old woman was experiencing, who presented with a 4-day history of painful swelling on the left side of the neck. The consumption-related symptom is common among those with her diagnosis. Assessment A tender, firm, warm swelling was identified in the patient’s left submandibular region. Intraoral examination revealed a hard […]

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30-Day Readmissions After an Acute Kidney Injury Hospitalization

The risk of hospital readmission in acute kidney injury survivors is not well understood. We estimated the proportion of acute kidney injury patients who were rehospitalized within 30 days and identified characteristics associated with hospital readmission. Methods We conducted a population-based study of patients who survived a hospitalization complicated by acute kidney injury from 2003-2013 […]

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Intermittent Gastric Volvulus Mimicking Acute Coronary Syndrome

Intermittent gastric volvulus plagued a 61-year-old white woman with chest pain for months before it was observed on esophagogastroduodenoscopy (EGD). She presented to the Emergency Department with complaints of progressively worsening localized, burning, left-sided and substernal chest pain that was identical to her previous myocardial infarction. Her chest pain was associated with nausea, vomiting, and […]

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stethoscope on a graphic of the U.S.A.

Healthcare Disparities Affecting Americans in the US Territories: A Century-Old Dilemma

In 1917, the Jones Act granted US citizenship to natives of Puerto Rico, the first among the 5 territories acquired by the United States since 1898.1 A dilemma in that early period—“Does the Constitution follow the flag?”—was addressed in several cases considered by the Supreme Court between 1901 and 1932, known as the “Insular Cases.”2 These decisions ultimately […]

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Heavy Cannabis Use Is Associated With Low Bone Mineral Density and an Increased Risk of Fractures

To investigate possible associations between recreational cannabis use and bone health in humans. Methods Cross-sectional study of individuals recruited from primary care in the UK between 2011 and 2013. Cases were regular smokers of cannabis divided into moderate (n = 56) and heavy user (n = 144) subgroups depending on whether they reported fewer or more than […]

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