The Consumption Gene

After years of pondering the over-testing, over-imaging, over-diagnosis, and over-treatment that typify US medicine, I have concluded that, like everything else, it must be genetic: We have evolved a gene that controls (or rather, disinhibits) consumption in all its forms. Although the gene has yet to be identified, I think it should be designated as […]

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American Journal of Medicine Editor Joseph Alpert

To Dig or Not to Dig

One of my colleagues here in Tucson thinks that digitalis therapy should be relegated to the medical trash heap alongside calomel, bleeding, and purging. I disagree, although digitalis therapy is certainly not as au courant today as it was when I was in training decades ago. Indeed, at that time, various forms of digitalis therapy […]

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tape measure

CME: Advances in the Management of Obesity

The American Journal of Medicine is offering a new continuing medical education course: Advances in the Management of Patients with Obesity. The course is based upon highlights from the 2013 Obesity Society Annual Meeting. Program Overview ObesityWeek 2013 was held on November 11–16, in Atlanta, GA and presented important data for the successful management of […]

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Cardiac Stress Testing

CME: Pharmacological Cardiac Stress Testing

The American Journal of Medicine and The American Journal of Cardiology are offering a new online continuing medical education (CME) course: Update on Pharmalogical Cardiac Stress Testing: Efficacy, Risk Stratification, and Patient Selection. Program Overview Given the rapidly evolving field of cardiac stress testing with respect to new risk stratification algorithms, new agents, and new […]

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Management of Hyponatremia

CME: Management of Patients with Hyponatremia

The American Journal of Medicine is offering a new continuing medical education course entitled: Advances in the Management of Patients with Hyponatremia. Program Overview This continuing medical education activity represents a comprehensive summary of the diagnosis and treatment of all types of hyponatremia. The expert faculty present specific treatment recommendations according to the extracellular fluid […]

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Joseph S. Alpert, MD

New Research: Stroke Rates Fall by 40% (video)

Incident strokes in the Medicare population fell by nearly 40% over the last 2 decades, a greater-than-expected decline. Check out Trends in Stroke Rates, Risk, and Outcomes in the United States, 1988 to 2008 the July 2014 issue of The American Journal of Medicine to learn more.

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Cardiac Rehabilitation, Readmissions, and Death After Acute MI

Participation in Cardiac Rehabilitation, Readmissions, and Death After Acute Myocardial Infarction Participation in cardiac rehabilitation has been shown to decrease mortality after acute myocardial infarction, but its impact on readmissions requires examination. Methods We conducted a population-based surveillance study of residents discharged from the hospital after their first-ever myocardial infarction in Olmsted County, Minnesota, from […]

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Muscle Mass Index As a Predictor of Longevity

Muscle Mass Index As a Predictor of Longevity in Older Adults   Obesity, as measured by body mass index (BMI), has not been associated consistently with higher mortality in older adults. This study reveals that muscle mass may be a better predictor of longevity than BMI. Objective Obesity (as defined by body mass index) has […]

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Less Exercise, Not More Calories, Responsible for Expanding Waistlines

Less Exercise, Not More Calories, Responsible for Expanding Waistlines Lack of Leisure-Time Physical Activity Linked to Increased Obesity, Particularly in Young Women, Reports The American Journal of Medicine Philadelphia, PA, July 7, 2014 – Sedentary lifestyle and not caloric intake may be to blame for increased obesity in the US, according to a new analysis […]

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Wyoming Institute of Technology Aspergers Article Is a Spoof

The Wyoming Institute of Technology (WIT) recently posted a satirical piece stating that The American Journal of Medicine will be publishing an article by WIT’s Dr. Franklin Forrester on the link between Aspergers syndrome and murder. Since the Journal’s editorial office has been contacted about this fake research article, we felt the need to clarify that this story is […]

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Chest Pain and Elevated Troponins in a Patient with Prior Coronary Artery Disease: A Diagnostic Dilemma

More than one quarter of patients hospitalized with congestive heart failure are readmitted within 30 days of discharge, with total annual costs surpassing $20 billion. In patients presenting with acute heart failure symptoms and chest pain, differentiating acute coronary syndrome from acute myocarditis is challenging. Newer imaging modalities, such as cardiac magnetic resonance imaging, can […]

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Pyrexia, Massive Hepatomegaly, and Extreme Hyperferritinemia

A 39-year-old woman presented with pyrexia. Extensive investigations showed negative results. On referral, she was febrile (41°C) and jaundiced, with a massive hepatomegaly to the pelvis. Clinical Summary Investigations showed a hemoglobin level of 9.3 g/dL, leukocyte level of 2.3×109/L, platelet level of 162×109/L, bilirubin level of 76 (4-23) μmol/L, alanine aminotransferase level of 94 […]

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Red-flag Syncope

Red-flag Syncope: Spontaneous Splenic Rupture Presentation After fainting in the lavatory, a healthy 59-year-old woman was taken to the hospital, where she would ultimately receive an unexpected diagnosis. On admission, she reported that she had been experiencing epigastric pain radiating to the left shoulder for several hours. Assessment The patient’s physical examination was remarkable for […]

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The Underlying ‘Inferno’

Thyroid Bruit and the Underlying ‘Inferno’ The normal thyroid has the most abundant blood flow of any tissue in the body. Early descriptions of color-flow Doppler ultrasonography in pathologic states of hyperthyroidism referred to the dramatic picture of elevated blood supply to the gland as the “thyroid inferno.”(1) Systolic-diastolic or systolic thyroid bruits have been […]

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