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

Difficulties in Teaching Diagnostic Reasoning in the Digital Age: The Critical Role of the Teacher-Clinician Mentor

Each case has its lesson—a lesson that may be, but is not always, learnt, for clinical wisdom is not the equivalent of experience. A man who has seen 500 cases of pneumonia may not have the understanding of the disease which comes with an intelligent study of a score of cases, so different are knowledge […]

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Geographic Tongue

A 45-year-old female patient presented to our clinic with a painless, erythematous lesion on her tongue. Medical history was negative, with absence of any allergies or habits. The patient recalled that she had a similar lesion on her tongue 6 months earlier, which resolved spontaneously. Clinical examination of the dorsal surface of the tongue revealed […]

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Dizziness Symptom Type Prevalence and Overlap: A US Nationally Representative Survey

  The traditional approach to dizziness encourages providers to emphasize the type of dizziness. However, symptom types might substantially overlap in individual patients, thus limiting the clinical value of this approach. We aimed to describe the overlap of types of dizziness using a US nationally representative sample. Methods The 2008 US National Health Interview Survey […]

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An Uncommon Cause of Low Back Pain

A 21-year-old active duty Air Force male without past medical history presented to our Emergency Department with low back pain. The patient had been performing general resistance strength training, including specific exercises focusing on the low back region, for about 2 months. A few hours after a workout session, he developed acute pain to the […]

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Urschel’s Sign in Paget Schroetter Syndrome

A 32-year-old man, employed as a deckhand, was referred for right upper extremity swelling and pain of 3 months’ duration. Physical examination revealed swelling of the right upper extremity and prominent superficial veins over the right upper arm and shoulder (Urschel’s sign; Figure). Blood work including thrombophilia screen was unremarkable. Right upper extremity venous duplex ultrasonography […]

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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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‘Landolfi’s Sign’—Eyes Don’t See What the Mind Does Not Know!

To the Editor: A 60-year-old woman was admitted with progressively worsening dyspnea on exertion associated with intermittent lightheadedness and palpitations. On physical examination, a 3/6 diastolic decrescendo murmur was audible along the left sternal border. The murmur was most prominently heard in the left third intercostal space at end expiration with the patient in the […]

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Sometimes the Eyes Say More Than the Mouth

A 48-year-old man with a history of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS)-associated cryptococcal meningitis was referred to our hospital with blurred vision in his left eye for several months. He was diagnosed with bilateral chronic posterior uveitis (Figure). After ruling out secondary uveitis, such as sarcoidosis, Behçet disease, Vogt-Koyanagi-Harada disease, […]

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Nutritional Nightmare: Hypoparathyroidism Secondary to Celiac Disease

A 33-year-old woman with history of diverticulitis status post hemicolectomy and idiopathic hypoparathyroidism presented with tetany and facial twitching for 3 months. She was transferred to a tertiary medical center for refractory tetany. She presented to her physician earlier in the week for diffuse muscle cramps and facial twitching. On review of her medical record, […]

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The Hyperlipidemia Effect: Pseudohyponatremia in Pancreatic Cancer

A patient’s newly discovered malignancy was evidently accompanied by a sodium deficit. The 48-year-old man presented to the Emergency Department for evaluation of abdominal pain and weight loss. He described gradual onset of severe, burning, epigastric pain with radiation to the back. In addition, he reported a 70-lb weight loss over 2 months, yellowing of […]

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pregnant woman getting check up

High Prevalence and Clinical/Sociodemographic Correlates of Miscarriages Among Flight Attendants

There are many occupational health hazards associated with long hours of air travel, including cosmic radiation exposure, circadian rhythm disruptions, prior and secondhand smoke exposure, for flight attendants who flew before smoking bans were initiated in the 1990s. Previous studies in flight attendants have found increased incidence of breast cancer and melanoma. However, there is […]

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