American Journal of Medicine, internal medicine, medicine, health, healthy lifestyles, cancer, heart disease, drugs
Axial T2-weighted image at the level of the C5-C6 intervertebral disc. The thecal sac (between arrowheads) is severely compressed, measuring 3 mm in anteroposterior diameter.

A Fateful Miss: Ground-Level Fall Revealing Occult Cervical Spinal Stenosis

A 67-year-old man was admitted after a fall at home. He intended to sit down, but the chair was not where he thought it was, and he fell on his buttocks in the sitting position. He was brought to the emergency department complaining of inability to walk and difficulty voiding. Medical history included obesity, diabetes, […]

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Clinical presentation patterns of AF versus likelihood of detection with monitoring. Dark bars indicate times that AF is present. AF = atrial fibrillation; ECV = elective cardioversion.

Mass Screening for Atrial Fibrillation: The Hype, The Methods, and The Application

Recently, Apple launched new heart-related features for their Apple Watch, including an app cleared by the US Food and Drug Administration that notifies wearers if atrial fibrillation has occurred. Apple admits, however, that the watch cannot detect all episodes; inconclusive results are possible; and it is not intended for people with known atrial fibrillation.1 Notably, this comes shortly […]

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Real-Life Benefits of Statins for Cardiovascular Prevention in Elderly Subjects: A Population-Based Cohort Study

The benefits of initiating statins in the elderly remains debated. We evaluated the effects of initiating statins in the elderly, according to cardiovascular risk. Methods This population-based cohort study used data of the representative sample of the French health care system database for the 2008-2015 period. New users of statins, aged 75 years and older, […]

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Multiple vesicular lesions on an erythematous base.

Fever and Rash in an Adult: Varicella Re-infection in Conjunction with Newly Diagnosed Chronic Lymphocytic Leukemia

A 36-year-old otherwise healthy white man presented to our hospital with fever and generalized rash. Symptoms initially started with a few painless, nonpruritic “pimples” at the back of his scalp that he had noted after a haircut. Within 24 hours, the lesions spread to his face, neck, and trunk. They continued to evolve despite empiric […]

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New Treatment Options for Depression: A Primer for Internists

Depression continues to be a challenging condition to treat despite the myriad treatment options available. Primary care providers are increasingly tasked with providing second- and third-line treatments for major depressive disorder, and thus, should be familiar with newer medication therapies that are available. In this article, we aim to provide the general internist and other […]

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Outdoor Portrait Of Medical Team

An Alternative to Medicare for All

  Two facts about US health care are beyond dispute. First, US health care is the most expensive in the world; it is twice as expensive as the average industrial nation.1, 2 Second, US health care is not the best health care system in the world. Four different studies have compared US health care to other […]

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Joseph S. Alpert

How Accurate Are the Findings Noted During a Physical Examination?

  When I was in training, it was common knowledge that the observations we made when examining patients were important ones that enabled us to accurately diagnose the patient’s disease. Since then, a number of physical findings have been shown to be either inaccurate or less than helpful in diagnosing disease states. For example, I […]

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Pulse Pressure, Cardiovascular Events, and Intensive Blood-Pressure Lowering in the Systolic Blood Pressure Intervention Trial (SPRINT)

The efficacy and tolerability of intensive blood-pressure lowering may vary by pulse pressure (systolic minus diastolic blood pressure). Methods SPRINT randomized 9361 high-risk adults without diabetes and who were ≥50 years with systolic blood pressure 130-180 mm Hg to intensive or standard antihypertensive treatment. The primary efficacy end point was the composite of acute coronary […]

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doctor uses tablet with patient

Burden of 30-Day Readmissions Associated With Discharge Against Medical Advice Among Inpatients in the United States

Discharges against medical advice are common among inpatients in the United States. The impact of discharge against medical advice on readmission rates and subsequent hospitalization outcomes is uncertain. We sought to ascertain the effect of discharge against medical advice on 30-day readmission rates and outcomes of readmission. Methods We used the 2014 Nationwide Readmissions Database […]

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