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The Role of the Environment in Health Outcomes

Disparities in health outcomes in the United States and other high-income countries have been widely discussed in recent years.1, 2, 3, 4 Many reasons have been suggested for these disparities, including the income levels of individuals, their educational attainment and employment status, as well as a variety of neighborhood socioeconomic and environmental factors. During my many years of inpatient […]

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Joseph S. Alpert, MD

Are You Planning to Sign Up for a Trip to Mars? Extreme Environmental Health Consequences of Space Travel

In this issue of The American Journal of Medicine, Lipman et al report on therapy for a serious environmental medical condition.1 My commentary below describes an even more serious environmental condition with multiple dangerous and even life-threatening consequences. Recently, one of my colleagues and I at the University of Arizona heard a lecture by one of the retired […]

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Disposing of Unused Medications: Have We Been Doing It All Wrong?

Most physicians probably give little thought to the estimated 10%-30% of medications that patients don’t end up consuming.1, 2 On the rare occasion when patients do ask their doctors where to dispose of unused medications, a physician could hardly be criticized for recommending disposal in the household garbage. Indeed, until recently, trash disposal was assumed by most […]

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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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desert

Coccidioidomycosis with Pericardial Involvement: Case Report and Literature Review

  Coccidioidomycosis, an infection caused by dimorphic fungi Coccidioides immitis and C. posadasii, is endemic to the southwestern US. It is estimated that there are 150,000 new infections in the US every year. Patients with primary infection are asymptomatic 60% of the time, and 40% have a wide spectrum of clinical manifestations, most commonly a community-acquired pneumonia. Overall, <1% develop […]

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