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

Suboptimal Addiction Interventions for Patients Hospitalized with Injection Drug Use-Associated Infective Endocarditis

Infective endocarditis is a serious infection, often resulting from injection drug use. Inpatient treatment regularly focuses on management of infection without attention to the underlying addiction. We aimed to determine the addiction interventions done in patients hospitalized with injection drug use-associated infective endocarditis. Methods This is a retrospective review of patients hospitalized with injection drug […]

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Postcardiac Injury Syndrome: A Rare Complication of Elective Coronary Angioplasty

Postcardiac injury syndrome conventionally has been described after myocardial infarction or cardiac surgery, but it is an infrequent complication of endovascular procedures. We report an unusual case of postcardiac injury syndrome occurring immediately after elective angioplasty. A 58-year-old man attended our hospital (Northwick Park Hospital) for elective angiography for symptoms of exertional angina. He had […]

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An Unusual Cause of Abdominal Pain: Lupus Enteritis

Lupus enteritis is a rare manifestation of systemic lupus erythematous and is considered as a form of visceral vasculitis involving predominantly the jejunum and ileum, with subsequent submucosal edema. Clinical presentation is nonspecific, and main symptoms include focal or diffuse abdominal pain, vomiting, diarrhea, and fever. Even if there is no pathognomonic imaging feature of lupus […]

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pregnant woman getting check up

Dissecting the Dilemma: Uncontrolled Hypertension in a Pregnant Patient

A 27-year-old G4P1021 African American woman presented at 9 weeks’ gestation with elevated blood pressure. The patient was otherwise asymptomatic, denying headache, vision changes, chest pain, shortness of breath, or neurologic symptoms. Her previous pregnancies were uncomplicated, with no history of hypertensive disorders of pregnancy. She had a 2-year history of chronic hypertension but had […]

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Objectively Measured Physical Activity and Symptoms Change in Knee Osteoarthritis

  The study objective was to quantify the association between daily physical activity measured by accelerometer and 1-year changes in symptoms among people with knee osteoarthritis. Methods Participants from the Osteoarthritis Initiative had knee radiographs and physical activity assessed using GT1M ActiGraph (Pensacola, FL) uniaxial accelerometers at the 48-month visit. Physical activity was calculated and […]

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Using Science to Battle Stigma in Addressing the Opioid Epidemic: Opioid Agonist Therapy Saves Lives

In 1965, Dole and Nyswander published the first study of methadone maintenance treatment for opioid use disorder. On the basis of research conducted at The Rockefeller Institute for Medical Research with Kreek, they described the treatment of 22 individuals with methadone for chronic heroin addiction. In this landmark study, they reported the notable findings of craving […]

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close up of a mosquito on skin

Zika: Should The Games Go On?

The Zika virus, a mosquito-born disease, has been linked to microcephaly, a devastating birth defect. The virus has spread across Brazil and into other South American countries as it marches north to the US. The Centers for Disease Control and Prevention (CDC) has been issuing regular announcements and using social media, particularly Twitter, to disseminate […]

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Staphylococcus aureus Bacteremia Masquerading as Leukocytoclastic Vasculitis

A 34-year-old Hispanic man with a history of alcoholic cirrhosis and type 2 diabetes mellitus presented with 2 weeks of diarrhea, nausea, vomiting, abdominal pain, rash, and syncope. Five days before presentation he developed an erythematous petechial rash on his right hand that spread sequentially to his left hand, forearms, feet, legs, and flanks. The […]

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Joseph S. Alpert

Endocarditis is Alive and Well, Unfortunately (video)

During a recent 2-week tour of duty as the attending physician on one of our busy Internal Medicine services, I saw 3 patients with complicated infective endocarditis. All of these individuals were active or former parenteral street-drug users, a factor that undoubtedly led to their intracardiac infection. I recounted for my housestaff team a quote from […]

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Lead Exposure Through Eating Wild Game

People generally reject the idea of injecting toxic substances into food, except when it involves hunting wild game. Perhaps surprising to nonhunters, up to 95% of hunters use lead projectiles, despite nonlead projectiles offering a suitable alternative. The use of nonlead projectiles eliminates lead exposure experienced through eating wild game. Hunters are not averse to using lead-free […]

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