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

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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young female doctor examines x-ray

High-Value, Cost-Conscious Care: Iterative Systems-Based Interventions to Reduce Unnecessary Laboratory Testing

Inappropriate testing contributes to soaring healthcare costs within the United States, and teaching hospitals are vulnerable to providing care largely for academic development. Via its “Choosing Wisely” campaign, the American Board of Internal Medicine recommends avoiding repetitive testing for stable inpatients. We designed systems-based interventions to reduce laboratory orders for patients admitted to the wards […]

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