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

The Call for a Physical Activity Vital Sign in Clinical Practice

According to the Bureau of Labor Statistics, the most common shared occupational health risk is sedentary behavior. Physical inactivity increases the relative risk of coronary artery disease, stroke, hypertension, and osteoporosis by 45%, 60%, 30%, and 59%, respectively. Epidemiologic data suggest that physical inactivity is associated with an increased risk of 25 chronic diseases. Because approximately 90% […]

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An Evidence-Based Approach to Differentiating the Cause of Shoulder and Cervical Spine Pain

  Differentiating the cause of pain and dysfunction due to cervical spine and shoulder pathology presents a difficult clinical challenge in many patients. Furthermore, the anatomic region reported to be painful may mislead the practitioner. Successfully treating these patients requires a careful and complete history and physical examination with appropriate provocative maneuvers. An evidence-based selection […]

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Lipid Management Guidelines from the Departments of Veteran Affairs and Defense: A Critique

In December 2014, the US Department of Veterans Affairs and Department of Defense (VA/DoD) published an independent clinical practice guideline for the management of dyslipidemia and cardiovascular disease risk, adding to the myriad of recently published guidelines on this topic. The VA/DoD guidelines differ from major US guidelines published by the American College of Cardiology/American […]

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Site of Treatment for Non-Urgent Conditions by Medicare Beneficiaries: Is There a Role for Urgent Care Centers?

  There is limited information on where and how often Medicare beneficiaries seek care for non-urgent conditions when a physician office visit is not available. Emergency departments are often an alternative site of care, and urgent care centers have now also emerged to fill this need. The purpose of the study was to characterize the […]

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doctor holds tablet and talks to patient

Top 10 List for the Cardiovascular Care of Older Adults

Cardiovascular medicine is disease oriented, technology driven, evidence rich, and focused on saving lives. Geriatric medicine is syndrome oriented, technology-avoiding, multidisciplinary, and focused on preserving quality of life. The tenets of these disciplines are divergent, yet their integration affords a richer platform for the cardiovascular care of older adults.1 Cardiovascular guidelines recommend treatment based upon evidence […]

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Unnecessary Hospitalizations for Pulmonary Embolism: Impact on US Health Care Costs

  Each year, more than 350,000 patients are treated for pulmonary embolism in US hospitals. Recent reports indicate that the majority of these patients do not have to be hospitalized: they can be safely treated at home, which will result in a tremendous decrease in our health care costs. One of the first reports that […]

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airplane on a runway

Prevention of Medical Events During Air Travel: A Narrative Review

Prior to traveling, and when seeking medical pretravel advice, patients consult their personal physicians. Inflight medical issues are estimated to occur up to 350 times per day worldwide (1/14,000-40,000 passengers). Specific characteristics of the air cabin environment are associated with hypoxia and the expansion of trapped gases into body cavities, which can lead to harm. […]

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Nutraceuticals: Evidence of Benefit in Clinical Practice?

Nutraceuticals, according to Wikipedia, are food substances or nutritional supplements that have beneficial effects on health. They are not usually considered to be part of a normal diet, such as fruit, vegetable, fish, and meat. Rather, they are additives, usually derived from plants, which are said to be beneficial at preventing or treating illnesses. The term nutraceutical, […]

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Pneumopericardium Following Pericardiocentesis

A 73-year-old woman with metastatic adenocarcinoma of the lung including diffuse pulmonary involvement presented with profound dyspnea. An echocardiogram demonstrated a large circumferential pericardial effusion with tamponade physiology. Palliative echo-guided pericardiocentesis was performed, with removal of 550 mL of fluid, and a multi-sidehole pericardial catheter was left to gravity drainage. Despite evacuation of the effusion, […]

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Multiple System Atrophy Mistaken for Autoimmune Cerebellar Degeneration

A 59-year-old African American woman with a history of Hashimoto thyroiditis presented with nearly 1 year of progressively worsening ataxia, dysarthria, and illegible handwriting. She had been thoroughly worked up at an outside hospital and diagnosed with a rare, autoimmune ataxia related to Hashimoto thyroiditis. She further endorsed dizziness upon standing, dysphagia, falls, and increasing […]

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