<?xml version="1.0" encoding="UTF-8"?><rss version="2.0" xmlns:content="http://purl.org/rss/1.0/modules/content/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:atom="http://www.w3.org/2005/Atom" xmlns:sy="http://purl.org/rss/1.0/modules/syndication/" xmlns:georss="http://www.georss.org/georss" xmlns:geo="http://www.w3.org/2003/01/geo/wgs84_pos#" > <channel> <title> Comments for The American Journal of Medicine Blog </title> <atom:link href="https://amjmed.org/comments/feed/" rel="self" type="application/rss+xml" /> <link>https://amjmed.org</link> <description>'The Green Journal'</description> <lastBuildDate>Tue, 25 Jul 2017 21:51:31 +0000</lastBuildDate> <sy:updatePeriod> hourly </sy:updatePeriod> <sy:updateFrequency> 1 </sy:updateFrequency> <item> <title> Comment on On Immigration: Welcome to America! by Managing Editor </title> <link>https://amjmed.org/on-immigration-welcome-to-america/comment-page-1/#comment-7737</link> <dc:creator><![CDATA[Managing Editor]]></dc:creator> <pubDate>Wed, 24 May 2017 21:48:01 +0000</pubDate> <guid isPermaLink="false">https://amjmed.org/?p=4129#comment-7737</guid> <description><![CDATA[In reply to <a href="https://amjmed.org/on-immigration-welcome-to-america/comment-page-1/#comment-7702">Shereef Hilmy</a>. Response I agree completely with the expressed feelings about illegal immigrants. However, President Trump has made a number of statements where he specifically did not say he was speaking about illegal immigrants. His major problem is that he often does not think before he speaks and ends up inflaming the populace against many immigrant groups who are here legally. I can tell you that many of our trainees are from the Middle East, Pakistan, and India. They uniformly feel that President Trump's remarks were aimed at them and made them very uncomfortable. I certainly agree that we need to keep our borders secure, but we should not disparage the many, many legal immigrants who come to the US every day. President Trump's remarks to the Muslim family whose son was killed fighting for the US were particularly unpleasant. He appeared to have no empathy for this bereaved family. I agree with a number of the things that he said during his campaign except for his remarks on immigration. They were poorly thought out like a some of his subsequent comments. Joseph Alpert, MD]]></description> <content:encoded><![CDATA[<p>In reply to <a href="https://amjmed.org/on-immigration-welcome-to-america/comment-page-1/#comment-7702">Shereef Hilmy</a>.</p> <p>Response<br /> I agree completely with the expressed feelings about illegal immigrants. However, President Trump has made a number of statements where he specifically did not say he was speaking about illegal immigrants. His major problem is that he often does not think before he speaks and ends up inflaming the populace against many immigrant groups who are here legally. I can tell you that many of our trainees are from the Middle East, Pakistan, and India. They uniformly feel that President Trump’s remarks were aimed at them and made them very uncomfortable. I certainly agree that we need to keep our borders secure, but we should not disparage the many, many legal immigrants who come to the US every day. President Trump’s remarks to the Muslim family whose son was killed fighting for the US were particularly unpleasant. He appeared to have no empathy for this bereaved family. I agree with a number of the things that he said during his campaign except for his remarks on immigration. They were poorly thought out like a some of his subsequent comments. Joseph Alpert, MD</p> ]]></content:encoded> </item> <item> <title> Comment on On Immigration: Welcome to America! by Shereef Hilmy </title> <link>https://amjmed.org/on-immigration-welcome-to-america/comment-page-1/#comment-7702</link> <dc:creator><![CDATA[Shereef Hilmy]]></dc:creator> <pubDate>Sat, 06 May 2017 20:20:19 +0000</pubDate> <guid isPermaLink="false">https://amjmed.org/?p=4129#comment-7702</guid> <description><![CDATA[To: Dr. Joseph S. Alpert, Professor of Medicine, University of Arizona College of Medicine, Tucson, Arizona Editor in Chief, The American Journal of Medicine Re.: On Immigration: Welcome to America Article in American Journal of Medicine, April 2017, Volume 130, Number 4. Dear Dr. Alpert: I read your editorial article captioned above with great interest. Like the many successful immigrants you cited, I too am an immigrant. I came to this country from Egypt and went through the appropriate credentialing and equivalency testing to be able to undergo internship, residency and fellowship training in this country. More importantly, I came to this country LEGALLY through the process of legal immigration. I too have had a long career in medicine. I also have participated in educating both American and foreign medical students and residents. As an immigrant to this wonderful country of opportunity, I feel that I can evaluate the immigration issue with objectivity. In reading your article, I could not help but note a degree of misrepresentation of the facts. I have no particular alliance with any political body. I, however, feel that facts should be presented properly. In disagreeing with President Trump, you imply that he is against all immigrants, which I think is less than factual. Even though I disagree with numerous policies proposed by Mr. Trump I have noted some of his statements on multiple occasions where he clearly stated that he welcomed LEGAL immigrants. His main concern lies with illegal aliens coming to this country without due process. I believe in each country’s right to control its borders by any means. Moreover, each country should be allowed to pick and choose which immigrants should be allowed into their midst. The selection should be based on merit and benefit to the society, but the process has to be lawful and legal. Your statement of disagreeing with President Trump is somewhat perplexing. I truly doubt that the majority of physicians you have trained were in the US illegally. I believe that the majority if not all had gone through the proper channels and procedures and were here with proper work permits and/or residency documents. When I applied for immigration to this wonderful country, I was almost declined a permanent residence status, which I would have accepted without question. Since the American Journal of Medicine is a respectable and widely circulated journal I believe it is prudent to set the facts straight by stating that President Trump’s objections pertain to illegal aliens. As opposed to numerous other policies of President Trump and his administration, I whole-heartedly support his position on LEGAL immigration. Shereef Hilmy, M.D., F.A.C.C. Associate Professor of Medicine University of Texas Health Science Center San Antonio, Texas]]></description> <content:encoded><![CDATA[<p>To: Dr. Joseph S. Alpert,<br /> Professor of Medicine, University of Arizona<br /> College of Medicine, Tucson, Arizona<br /> Editor in Chief, The American Journal of Medicine</p> <p>Re.: On Immigration: Welcome to America<br /> Article in American Journal of Medicine, April 2017, Volume 130, Number 4.</p> <p>Dear Dr. Alpert:</p> <p>I read your editorial article captioned above with great interest. Like the many successful immigrants you cited, I too am an immigrant. I came to this country from Egypt and went through the appropriate credentialing and equivalency testing to be able to undergo internship, residency and fellowship training in this country. More importantly, I came to this country LEGALLY through the process of legal immigration. I too have had a long career in medicine. I also have participated in educating both American and foreign medical students and residents. </p> <p>As an immigrant to this wonderful country of opportunity, I feel that I can evaluate the immigration issue with objectivity. In reading your article, I could not help but note a degree of misrepresentation of the facts.</p> <p>I have no particular alliance with any political body. I, however, feel that facts should be presented properly. In disagreeing with President Trump, you imply that he is against all immigrants, which I think is less than factual. Even though I disagree with numerous policies proposed by Mr. Trump I have noted some of his statements on multiple occasions where he clearly stated that he welcomed LEGAL immigrants. His main concern lies with illegal aliens coming to this country without due process.</p> <p>I believe in each country’s right to control its borders by any means. Moreover, each country should be allowed to pick and choose which immigrants should be allowed into their midst. The selection should be based on merit and benefit to the society, but the process has to be lawful and legal.</p> <p>Your statement of disagreeing with President Trump is somewhat perplexing. I truly doubt that the majority of physicians you have trained were in the US illegally. I believe that the majority if not all had gone through the proper channels and procedures and were here with proper work permits and/or residency documents. </p> <p>When I applied for immigration to this wonderful country, I was almost declined a permanent residence status, which I would have accepted without question.</p> <p>Since the American Journal of Medicine is a respectable and widely circulated journal I believe it is prudent to set the facts straight by stating that President Trump’s objections pertain to illegal aliens. As opposed to numerous other policies of President Trump and his administration, I whole-heartedly support his position on LEGAL immigration. </p> <p>Shereef Hilmy, M.D., F.A.C.C.<br /> Associate Professor of Medicine<br /> University of Texas Health Science Center<br /> San Antonio, Texas</p> ]]></content:encoded> </item> <item> <title> Comment on On Immigration: Welcome to America! by Russell leewood md </title> <link>https://amjmed.org/on-immigration-welcome-to-america/comment-page-1/#comment-7701</link> <dc:creator><![CDATA[Russell leewood md]]></dc:creator> <pubDate>Sat, 06 May 2017 17:37:19 +0000</pubDate> <guid isPermaLink="false">https://amjmed.org/?p=4129#comment-7701</guid> <description><![CDATA[I enjoy dr Alpert' s editorials but have to comment on this one.dr Alpert implies that the president is intending to halt all immigration. Hardly true Let us not confuse immigration in general with illegal immigration. Physicians here illegally should not and i am sure are not practicing medicine.thus enforcing the existing laws as the president is required to do hardly impacts us medicine I am a fairly recent immig/rant and went through the appropriate steps.why would this be an issue for other physicians? The pathway exists. I feel that blanket statements like welcome to America are naive and meaningless. The welcome has always been there-but just do it legally. Finally, fmg's are frequently some of the best physicians in the us and an asset to their communities. But for many countries this is a loss of a trained professional that can be ill afforded-the term brain drain still has meaning.]]></description> <content:encoded><![CDATA[<p>I enjoy dr Alpert’ s editorials but have to comment on this one.dr Alpert implies that the president is intending to halt all immigration. Hardly true</p> <p>Let us not confuse immigration in general with illegal immigration. Physicians here illegally should not and i am sure are not practicing medicine.thus enforcing the existing laws as the president is required to do hardly impacts us medicine</p> <p>I am a fairly recent immig/rant and went through the appropriate steps.why would this be an issue for other physicians? The pathway exists.</p> <p>I feel that blanket statements like welcome to America are naive and meaningless. The welcome has always been there-but just do it legally.</p> <p>Finally, fmg’s are frequently some of the best physicians in the us and an asset to their communities. But for many countries this is a loss of a trained professional that can be ill afforded-the term brain drain still has meaning.</p> ]]></content:encoded> </item> <item> <title> Comment on Dipeptidyl Peptidase-4 Inhibitors, Peripheral Arterial Disease, and Lower Extremity Amputation Risk in Diabetic Patients by Kelley Bisher </title> <link>https://amjmed.org/dipeptidyl-peptidase-4-inhibitors-peripheral-arterial-disease-and-lower-extremity-amputation-risk-in-diabetic-patients/comment-page-1/#comment-7699</link> <dc:creator><![CDATA[Kelley Bisher]]></dc:creator> <pubDate>Fri, 05 May 2017 10:17:44 +0000</pubDate> <guid isPermaLink="false">https://amjmed.org/?p=4118#comment-7699</guid> <description><![CDATA[It was a crisis for me when my father was having a seizure after a stroke in the emergency room but every nurse on staff was needed because a gang of 12 illegal Columbians had come to ER all bloodied up and beaten after a fight. The nurse told me this happens AT LEAST ONCE A WEEK and there's nothing they can do about it. My father was a WWII vet who paid his taxes and never broke a law or asked anyone for anything and there he was lying there without even a sheet on him, shaking and moaning and no one could attend to him for 30 minutes because a worthless bunch of criminals decided to cause trouble. And guess who pays for their medical care? You and me. Yes, there are very bad illegals that come to this country. There are also good people, I get that. But the laws need to be enforced so that we can get the bad ones out. I don't think that's a unreasonable position.]]></description> <content:encoded><![CDATA[<p>It was a crisis for me when my father was having a seizure after a stroke in the emergency room but every nurse on staff was needed because a gang of 12 illegal Columbians had come to ER all bloodied up and beaten after a fight. The nurse told me this happens AT LEAST ONCE A WEEK and there’s nothing they can do about it. My father was a WWII vet who paid his taxes and never broke a law or asked anyone for anything and there he was lying there without even a sheet on him, shaking and moaning and no one could attend to him for 30 minutes because a worthless bunch of criminals decided to cause trouble. And guess who pays for their medical care? You and me. Yes, there are very bad illegals that come to this country. There are also good people, I get that. But the laws need to be enforced so that we can get the bad ones out. I don’t think that’s a unreasonable position.</p> ]]></content:encoded> </item> <item> <title> Comment on Dipeptidyl Peptidase-4 Inhibitors, Peripheral Arterial Disease, and Lower Extremity Amputation Risk in Diabetic Patients by Lap Band Surgery </title> <link>https://amjmed.org/dipeptidyl-peptidase-4-inhibitors-peripheral-arterial-disease-and-lower-extremity-amputation-risk-in-diabetic-patients/comment-page-1/#comment-7696</link> <dc:creator><![CDATA[Lap Band Surgery]]></dc:creator> <pubDate>Thu, 04 May 2017 21:09:36 +0000</pubDate> <guid isPermaLink="false">https://amjmed.org/?p=4118#comment-7696</guid> <description><![CDATA[In the case that your body often tends towards insulin resistance, that propensity will not ever disappear as well as the relevance of the concern with diabetic issues. A bariatric operation can help in lowering your blood glucose numbers and also you could get to an aspect where you do not need to take any type of medicines, yet you will constantly be required to recognize that if you gain back the (previous) weight, the diabetes mellitus will potentially return. Article - http://aaslink.co/gastric]]></description> <content:encoded><![CDATA[<p>In the case that your body often tends towards insulin resistance, that propensity will not ever disappear as well as the relevance of the concern with diabetic issues. A bariatric operation can help in lowering your blood glucose numbers and also you could get to an aspect where you do not need to take any type of medicines, yet you will constantly be required to recognize that if you gain back the (previous) weight, the diabetes mellitus will potentially return. Article – <a href="http://aaslink.co/gastric" rel="nofollow ugc">http://aaslink.co/gastric</a></p> ]]></content:encoded> </item> <item> <title> Comment on An Uncommon Cause of Obstructive Jaundice: An Infrequent Neoplasm by geriatric care specialist </title> <link>https://amjmed.org/an-uncommon-cause-of-obstructive-jaundice-an-infrequent-neoplasm/comment-page-1/#comment-7536</link> <dc:creator><![CDATA[geriatric care specialist]]></dc:creator> <pubDate>Fri, 03 Mar 2017 12:22:06 +0000</pubDate> <guid isPermaLink="false">https://amjmed.org/?p=4023#comment-7536</guid> <description><![CDATA[Hi! Thank you...Useful article!.]]></description> <content:encoded><![CDATA[<p>Hi! Thank you…Useful article!.</p> ]]></content:encoded> </item> <item> <title> Comment on How Can We Improve the Management of Patients with Hypertension? by MJ Quinn </title> <link>https://amjmed.org/how-can-we-improve-the-management-of-patients-with-hypertension/comment-page-1/#comment-7490</link> <dc:creator><![CDATA[MJ Quinn]]></dc:creator> <pubDate>Thu, 12 Jan 2017 11:41:22 +0000</pubDate> <guid isPermaLink="false">https://amjmed.org/?p=3902#comment-7490</guid> <description><![CDATA[Dr Alpert makes a compelling case for self-monitoring of blood pressure that may be particularly helpful in those suffering from “dietary” hypertension (1, 2). Adherence to the Dietary Approaches to Stop Hypertension (DASH) diet has been shown to be effective for controlling hypertension, but multivariate linear regression does not identify the precise cause (3). IF, sustained hyperglycemia variably increases blood viscosity and blood pressure, then checking pre- and post-prandial (1-2 hours), blood glucose levels will enable a patient to titrate their diet and exercise against their blood sugar. A bowl of breakfast cereal may cause a sustained blood glucose of 12mM per litre and a BP of 150/100 mm that persists for 4 hours, whereas a dinner of vegetable curry may only cause a peak blood glucose of 6-7mM per litre and postprandial BP of 130/85 mm. Clearly, the precise effects of such dietary dosages of carbohydrates will vary within, and between, individuals, their glycogen stores, adrenaline levels, exercise etc. though they are displayed in real time by a simple, home glucose monitor enabling precise control. Self-monitoring technologies are simple, accurate and well-established; they provide the basis for “precision, lifestyle, medicine” particularly in preventing type 2 diabetes, hypertension and cardiovascular disease. References (1) Alpert JS. How Can We Improve the Management of Patients with Hypertension? Am J Med. 2017 Jan;130(1):1-2. (2) Rebholz CM, Crews DC, Grams ME, Steffen LM, Levey AS, Miller ER, et al. DASH (Dietary Approaches to Stop Hypertension) Diet and Risk of Subsequent Kidney Disease. Am J Kidney Dis. 2016 Dec;68(6):853-861. (3) Blumenthal J.A., Babyak M.A., Hinderliter A. Effects of the DASH diet alone and in combination with exercise and weight loss on blood pressure and cardiovascular biomarkers in men and women with high blood pressure: the ENCORE study. Arch. Intern. Med. 2010;170(2):126.]]></description> <content:encoded><![CDATA[<p>Dr Alpert makes a compelling case for self-monitoring of blood pressure that may be particularly helpful in those suffering from “dietary” hypertension (1, 2). Adherence to the Dietary Approaches to Stop Hypertension (DASH) diet has been shown to be effective for controlling hypertension, but multivariate linear regression does not identify the precise cause (3). IF, sustained hyperglycemia variably increases blood viscosity and blood pressure, then checking pre- and post-prandial (1-2 hours), blood glucose levels will enable a patient to titrate their diet and exercise against their blood sugar. A bowl of breakfast cereal may cause a sustained blood glucose of 12mM per litre and a BP of 150/100 mm that persists for 4 hours, whereas a dinner of vegetable curry may only cause a peak blood glucose of 6-7mM per litre and postprandial BP of 130/85 mm. Clearly, the precise effects of such dietary dosages of carbohydrates will vary within, and between, individuals, their glycogen stores, adrenaline levels, exercise etc. though they are displayed in real time by a simple, home glucose monitor enabling precise control. </p> <p>Self-monitoring technologies are simple, accurate and well-established; they provide the basis for “precision, lifestyle, medicine” particularly in preventing type 2 diabetes, hypertension and cardiovascular disease. </p> <p>References</p> <p>(1) Alpert JS.<br /> How Can We Improve the Management of Patients with Hypertension?<br /> Am J Med. 2017 Jan;130(1):1-2. </p> <p>(2) Rebholz CM, Crews DC, Grams ME, Steffen LM, Levey AS, Miller ER, et al.<br /> DASH (Dietary Approaches to Stop Hypertension) Diet and Risk of Subsequent Kidney Disease.<br /> Am J Kidney Dis. 2016 Dec;68(6):853-861.</p> <p>(3) Blumenthal J.A., Babyak M.A., Hinderliter A. Effects of the DASH diet alone and in combination with exercise and weight loss on blood pressure and cardiovascular biomarkers in men and women with high blood pressure: the ENCORE study. Arch. Intern. Med. 2010;170(2):126.</p> ]]></content:encoded> </item> <item> <title> Comment on ‘Thank You, Doctor’ Says It All by Managing Editor </title> <link>https://amjmed.org/thank-you-doctor-says-it-all/comment-page-1/#comment-7007</link> <dc:creator><![CDATA[Managing Editor]]></dc:creator> <pubDate>Tue, 26 Jan 2016 23:22:14 +0000</pubDate> <guid isPermaLink="false">https://amjmed.org/?p=2645#comment-7007</guid> <description><![CDATA[In reply to <a href="https://amjmed.org/thank-you-doctor-says-it-all/comment-page-1/#comment-7005">Michael Solomon MD</a>. Dear Dr. Solomon: I was very pleased reading your letter. I constantly tell my residents and medical students that despite all the bureaucratic impediments, medicine is still the best career one can have. Certainly, no one says thank you to the person who manufactures hand grenades!! Sincerely, Joseph Alpert]]></description> <content:encoded><![CDATA[<p>In reply to <a href="https://amjmed.org/thank-you-doctor-says-it-all/comment-page-1/#comment-7005">Michael Solomon MD</a>.</p> <p>Dear Dr. Solomon:<br /> I was very pleased reading your letter. I constantly tell my residents and medical students that despite all the bureaucratic impediments, medicine is still the best career one can have. Certainly, no one says thank you to the person who manufactures hand grenades!!<br /> Sincerely, Joseph Alpert</p> ]]></content:encoded> </item> <item> <title> Comment on Beyond Body Mass Index: Advantages of Abdominal Measurements by Erna Decosta </title> <link>https://amjmed.org/beyond-body-mass-index-advantages-of-abdominal-measurements-for-recognizing-cardiometabolic-disorders/comment-page-1/#comment-7006</link> <dc:creator><![CDATA[Erna Decosta]]></dc:creator> <pubDate>Tue, 26 Jan 2016 02:06:42 +0000</pubDate> <guid isPermaLink="false">https://amjmed.org/?p=2654#comment-7006</guid> <description><![CDATA[Very perceptive blog and a good post. Thanks!]]></description> <content:encoded><![CDATA[<p>Very perceptive blog and a good post. Thanks!</p> ]]></content:encoded> </item> <item> <title> Comment on ‘Thank You, Doctor’ Says It All by Michael Solomon MD </title> <link>https://amjmed.org/thank-you-doctor-says-it-all/comment-page-1/#comment-7005</link> <dc:creator><![CDATA[Michael Solomon MD]]></dc:creator> <pubDate>Mon, 25 Jan 2016 21:31:26 +0000</pubDate> <guid isPermaLink="false">https://amjmed.org/?p=2645#comment-7005</guid> <description><![CDATA[Dear Dr. Alpert; After reading your article I smiled. I rarely enjoy an article about the practice of medicine anymore as our role as "doctors" has been eroded to practitioners! Just today I had three long-time patients thank me for my opinions and medical advice. They had seen other very competent specialists, but wanted "their doctor's" opinion and confirmation of the appropriateness of care. They said that they really trusted my judgement. In each case I tried to spend enough time to insure a careful diagnosis and individualized treatment.I doubt if I could have been as effective were my eyes looking at a computer screen during a ten minute visit. My oldest patient today was 100! and she came after our NJ blizzard. Sincerely, Michael Solomon MD, Internal Medicine]]></description> <content:encoded><![CDATA[<p>Dear Dr. Alpert;<br /> After reading your article I smiled.<br /> I rarely enjoy an article about the practice of medicine anymore as our role as “doctors” has been eroded to practitioners!<br /> Just today I had three long-time patients thank me for my opinions and medical advice. They had seen other very competent specialists, but wanted “their doctor’s” opinion and confirmation of the appropriateness of care. They said that they really trusted my judgement. In each case I tried to spend enough time to insure a careful diagnosis and individualized treatment.I doubt if I could have been as effective were my eyes looking at a computer screen during a ten minute visit. My oldest patient today was 100! and she came after our NJ blizzard.<br /> Sincerely,<br /> Michael Solomon MD, Internal Medicine</p> ]]></content:encoded> </item> </channel> </rss>