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

Massive Asymptomatic Extrahepatic Portal Vein Aneurysm

A 59-year-old woman with no prior liver disease or portal hypertension presented with an episode of right upper quadrant pain that lasted for 3 hours. The patient had a history of cholelithiasis, which was diagnosed 3 years earlier. She denied any other symptoms. Her social and family history were unremarkable. Assessment Her examination was remarkable […]

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Cardiology Consultation in the Emergency Department

Re-hospitalization after discharge for acute decompensated heart failure is a common problem. Low-socioeconomic urban patients suffer high rates of re-hospitalization and often over-utilize the emergency department (ED) for their care. We hypothesized that early consultation with a cardiologist in the ED can reduce re-hospitalization and health care costs for low-socioeconomic urban patients with acute decompensated […]

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Unexpected Cause of Bleeding

To the Editor: A 46-year-old man was seen by his hepatologist for a follow-up visit after successful treatment of hepatitis C. He reported a general weakness and walking pain for 10 days due to lower limb edema and knee arthralgia. His medical history included an intravenous heroin and cocaine addiction weaned off since 2001 and […]

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Delayed Transient Cortical Blindness from Hypoxic Ischemic Encephalopathy

To the Editor: An 85-year-old woman with no significant past medical history presented after a mechanical fall complicated by multiple fractures. She received intravenous pain medications with resultant decreased level of consciousness and respiratory distress. Intubation was difficult because of bilateral mandibular fractures, and she consequently experienced 10 minutes of hypoxia before secure airway control […]

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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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Four Cancers and a Rash: Henoch–Schönlein Purpura

A patient who had a history of 4 primary malignancies developed a rash that is usually seen among children. The 65-year-old man presented with a 2-day history of anasarca, painless skin lesions, and new arthralgias in both hands. He had a previous diagnosis of amyotrophic dermatomyositis, and although he had none of the typical skin […]

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Bone Density Testing Is the Best Way to Monitor Osteoporosis Treatment

Bone mineral density assessment by dual-energy X-ray absorptiometry is the most widely available and best validated clinical tool to diagnose osteoporosis, assess fracture risk, and monitor the skeletal effects of medications that reduce fracture risk.1 However, dual-energy X-ray absorptiometry testing remains underused with osteoporosis undertreated. This treatment gap has reached crisis proportions,2 with recent disturbing evidence that […]

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Not so Obvious: Acute Herpes Esophagitis

  The gross examination immediately suggested infection with Candida species, but biopsy results pointed to a different culprit. A 29-year-old woman sought care in the emergency department after experiencing sharp epigastric pain over 2 days. She was initially seen at an urgent care center and empirically treated for gastritis with omeprazole. However, her pain progressively worsened and […]

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Gynecomastia: Look Beyond the Obvious

A 29-year-old man was referred to our clinic with a 4-week history of a tender predominant left breast enlargement without nipple discharge. He had been practicing bodybuilding regularly for years, but denied taking anabolic androgenic steroids. His past medical history was unremarkable apart from surgical treatment of undescended testes in childhood. His sexual desire and […]

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Torus Mandibularis

A 34-year-old male patient presented with asymptomatic bony overgrowth in his mandibular arch. The overgrowth started 5 years back and gradually kept on increasing to its present size. On intraoral examination, the bony overgrowth was present bilaterally on the lingual surface of the mandible from canine to first molar region, measuring about 1.4 cm × 1 […]

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