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

Top 10 Lessons Learned from Project Healthy Schools

Childhood obesity is increasing in the United States; obese children are more likely to become obese adults with obesity-associated health issues. Effective programs designed to reduce the prevalence of childhood overweight and obesity are needed. We sought to review one such program, Project Healthy Schools (PHS), for key findings. Project Healthy Schools is a health […]

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Denying International Medical Graduates Entry to the United States: A Loss at Both Ends

A resident colleague of ours at the Cleveland Clinic was recently deported soon after entering the United States. This was in conjunction with the executive orders at that time that barred individuals from selected countries to enter the United States, whereas suggesting “extreme vetting” for the others. She had traveled to spend vacation time with […]

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Osteoporosis in the Women’s Health Initiative: Another Treatment Gap?

Osteoporotic fractures are associated with high morbidity, mortality, and cost. Methods We performed a post hoc analysis of the Women’s Health Initiative (WHI) clinical trials data to assess osteoporosis treatment and identify participant characteristics associated with utilization of osteoporosis medication(s) after new diagnoses of osteoporosis or fracture. Information from visits prior to and immediately subsequent […]

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Concierge Medicine Is Here and Growing!!

An increasing number of primary care physicians are downsizing to a concierge medical practice (also termed “retainer-based medicine”). In a concierge medical practice, the physician limits the number of patients in his practice and offers exclusive services for an annual fee. The patient pays a surcharge for increased access and additional services from their physician.1 […]

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doctor putting on gloves

Digital Rectal Exam: Still Relevant After All These Years (video)

In the world of high-tech medicine, the digital rectal exam still has a place. In this current study, researchers showed that performing the digital rectal exam on patients with acute gastrointestinal bleeding provided valuable clinical information. American Journal of Medicine Editor-in-Chief Dr. Joseph S. Alpert explains the clinical implications of this research. (Get out your exam […]

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Why California’s Proposition 61 Was a Bad Idea

New approaches to control state pharmaceutical costs are needed.1 This issue is particularly critical in California, the state with the largest pharmaceutical expenditures in the country.1 A controversial California ballot initiative aimed at reining in prescription drug expenditures was defeated on November 8, 2016 by a 54% to 46% margin.2The California Drug Price Relief Act, also known […]

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Conquering ‘Neurophobia’

The evaluation of a patient with neurologic disease remains one of the most daunting and anxiety-provoking tasks in clinical medicine. From the perspective of physicians who are not trained in neurology, the performance and interpretation of the neurologic examination is shrouded in mystery. The angst associated with the study of neuroscience begins in medical school […]

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Joseph S. Alpert, MD

Polypharmacy in Elderly Patients: The March Goes On and On

Polypharmacy is a major public health problem in the United States and abroad. Although there is no standard definition of polypharmacy, I see and recognize it every day in the outpatient and inpatient environment. A typical example that I saw yesterday was an 84-year-old man admitted to our internal medicine service for worsening heart failure. […]

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surgical instruments laid out for use

The Complexities of Iron Deficiency in Patients After Bariatric Surgery

  To the Editor: Iron deficiency is one of the most common micronutrient deficiencies after bariatric surgery and is often overlooked by healthcare providers when patients present with vague symptoms or laboratory results do not demonstrate straightforward iron-deficiency anemia. Thus, it is imperative that providers order tests and interpret laboratory results carefully so they can […]

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The Malnourished Heart: An Unusual Case of Heart Failure

To the Editor: A 66-year-old woman with no past medical history was admitted for 3 months of worsening dyspnea, lower extremity edema, and orthopnea. She was not taking medications or supplements. She denied chest pain, recent infections, fevers, toxin exposures, or use of drugs or alcohol. She reported patchy hair loss on her scalp, bruises […]

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