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Multiple System Atrophy Mistaken for Autoimmune Cerebellar Degeneration

A 59-year-old African American woman with a history of Hashimoto thyroiditis presented with nearly 1 year of progressively worsening ataxia, dysarthria, and illegible handwriting. She had been thoroughly worked up at an outside hospital and diagnosed with a rare, autoimmune ataxia related to Hashimoto thyroiditis. She further endorsed dizziness upon standing, dysphagia, falls, and increasing […]

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Hands

A Diagnosis at Hand: Pulmonary Arterial Hypertension

A classic physical examination finding pointed to underlying disease in a 43-year-old Hispanic woman. On presenting to the Emergency Department, she reported progressive shortness of breath, fatigue, and chest pressure. One month earlier, she could exercise without limitation. However, in the ensuing interval, she developed increasing dyspnea and constant, nonexertional, left-sided chest pressure. A review […]

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Hospital Readmissions Following Physician Call System Change (video)

Reorganizing Physician Teams in a Large Hospital Caused Readmissions to Increase Significantly, According to New Report in The American Journal of Medicine As hospitals try to maintain effective and efficient operations, physician call systems can be a critical element in maintaining quality medical care and financial stability. In a new report published in The American […]

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Reading Level of Internet Medical Information for Common Diagnoses

The National Institutes of Health (NIH) recommend that health materials be written at a grade 6-7 reading level, which has generally not been achieved in online reading materials. Up to the present time, there have not been any assessments focused on the reading level of online educational materials across the most popular consumer Web sites […]

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(Panel A) Colonoscopy image of obstructed gallstone in sigmoid colon. (Panel B) Partially fragmented stone after electrohydraulic lithotripsy (EHL). (Panel C) Ulceration caused by passage of stone in sigmoid colon.

A Rare Cause of Large Bowel Obstruction

    A 64-year-old man presented with abdominal distension, pain, and vomiting for 5 days. Computed tomography scan of the abdomen showed dilated small intestine and colon, air in the biliary tree, and a calcified mass in the sigmoid colon. Colonoscopy showed a large impacted stone in the sigmoid colon. This was likely a migrated […]

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An Alternative Way to Provide Healthcare for Veterans

The Veterans Health Administration (VHA) has been under considerable scrutiny because of ongoing scandals; an independent evaluation found the VHA lacking. This article examined the cost impact of enrolling veterans (the 9.079 million who are currently enrolled in the VHA, the 6.633 million who use the VHA for care, or the 1.757 million VHA users […]

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