Practice Transformation in Chronic Care Management

Join ACP Quality Connect: Diabetes, an ABIM-approved practice improvement module. Receive free personal coaching and much more. Enroll now.

New PCMH Requirements for NCQA

Join ACP Quality Connect: Diabetes, an ABIM-approved practice improvement module. Receive free personal coaching and much more. Enroll now.

Helping the patient with "diabetes difficulties": Focus onpatients with A1c >9%

Join ACP Quality Connect: Diabetes, an ABIM-approved practice improvement module. Receive free personal coaching and much more. Enroll now.

Diabetes

Join ACP Quality Connect: Diabetes, an ABIM-approved practice improvement module. Receive free personal coaching and much more. Enroll now.

Clinical Update on Diabetes

Join ACP Quality Connect: Diabetes, an ABIM-approved practice improvement module. Receive free personal coaching and much more. Enroll now.

Care Coordination

Join ACP Quality Connect: Diabetes, an ABIM-approved practice improvement module. Receive free personal coaching and much more. Enroll now.

Adult Immunization & Quality Improvement for Residents

ACP residency program in adult immunization seeks to increase the rates of adult immunization by residents through education.

Atrial Fibrillation: Using Quality Improvement to Analyze and Transform Care and Management of Patients

ACP Quality Connect Atrial Fibrillation

ACP, in collaboration with the Heart Rhythm Society, has launched the ACP Quality Connect Atrial Fibrillation (AF), which provides participants with the skills to lead practice transformation and QI efforts, resulting in real and meaningful change in AF management and stroke prevention. The program takes a collaborative, team-based approach to implement practice transformation and QI strategies that improve care of patients with AF and help prevent stroke. The skills gained through participation can be applied to a number of other clinical conditions and quality challenges.

Quality Improvement in Healthcare | Resources and Programs | ACP

ACP Advance is a robust program that gives resources to help members and clinicians learn quality improvement in healthcare. Learn more.

Annals Consult Guys - Should Your Patient's Surgery Be Stopped for Hypertension? The Pressure Is On

Annals Story Slam - Clerks, Codes, and Culture, or “We Weren't Even Supposed to Be Here!”

Annals Story Slam - But You Used to Be a Man

Annals Story Slam - The Little Things

Annals Story Slam - The Gift

Annals Story Slam - A Time to Die

Annals Story Slam - Only at Temple

Annals Story Slam - Who Knew?

Annals Story Slam - Death of a Patient

Annals Story Slam - Getting to Know My People

Community health worker intervention improved anxiety, depression in minority patients

MKSAP Quiz: Pain, tenderness of multiple peripheral joints

Remote bone health service increased osteoporosis screening in high-risk men

CRC screening completion not improved by personalizing risk info

Put words in our mouth

Applications open for ACP's 2026 Health Policy Internship

Vaginal estradiol may be safe in women with prior ischemic stroke, study finds

MKSAP Quiz: Evaluation after a fall

COVID-19 vaccination effective when coadministered with flu, pneumonia shots

High-dose THC products linked with adverse mental health outcomes, review shows

Algorithm reduced antipsychotic medication use for delirium in older patients | ACP Hospitalist

Thin to win | ACP Hospitalist

Take a quiz about the Nov. 26 issue! | ACP Hospitalist

Steroids reduce short-term mortality in non-COVID-19 severe pneumonia, review finds | ACP Hospitalist

Preadmission GLP-1 receptor agonist use not linked with adverse ICU outcomes | ACP Hospitalist

Patients perceived as difficult across settings | ACP Hospitalist

IDSA statement explains society's position on community-acquired pneumonia guidelines | ACP Hospitalist

A piece of good news | ACP Hospitalist

The power of a physician's words | ACP Hospitalist

The missing blanket | ACP Hospitalist

Septic Diffuse Left Ventricular Calcification With Reversibility | Annals of Internal Medicine: Clinical Cases

This case report explores a patient with an underlying cancer diagnosis who developed severe left ventricular dysfunction and subsequent calcification postsepsis event. Incidentally, through imaging for cancer progression and clinical follow-up, the patient's left ventricular calcification was seen to be reversed.

Acute Anterior Uveitis Following Intravenous Zoledronate for Osteoporosis | Annals of Internal Medicine: Clinical Cases

Postmenopausal osteoporosis is a common health issue clinicians encounter in practice for which bisphosphonates are commonly prescribed with success. However, these agents may cause intolerable gastrointestinal side effects when administered orally. In such cases, intravenous (IV) bisphosphonates may be prescribed. Post-infusion transient side effects are common, but more uncommon severe adverse effects may develop. We report a case of acute anterior uveitis following the use of IV zoledronate.

Recurrent Strokes in a Hypertensive Smoker: An Atypical Case and Review of Thrombotic Thrombocytopenic Purpura | Annals of Internal Medicine: Clinical Cases

Thrombotic thrombocytopenic purpura (TTP) can present with neurologic symptoms before the development of typical hematologic abnormalities. We describe a patient presenting with decreased grip strength in his right hand who was found to have an ischemic stroke from acute TTP. In the setting of subtle hematologic abnormalities, detection of severely decreased ADAMTS13 activity aided in early diagnosis and prompt initiation of plasmapheresis. Hence, we emphasize the need for high clinical suspicion for TTP in patients with recurrent and cryptogenic strokes, especially in the setting of subtle hematologic findings, as early treatment decreases mortality rate by almost 90%.

Pouchitis After Immune Checkpoint Inhibitors | Annals of Internal Medicine: Clinical Cases

Immune checkpoint inhibitors (ICIs) are becoming increasingly used for various cancers, but their association with immune-related adverse events often leads to significant morbidity and mortality. Here we report 2 unusual cases of pouchitis after ICI therapy—treated with steroids and biologics. To our knowledge, this is the first example to be reported in literature. One patient achieved short-term remission, while the other achieved long-term remission without further flares.

Broadening the Differential for Obstructive Jaundice: Lemmel Syndrome | Annals of Internal Medicine: Clinical Cases

Lemmel syndrome describes the rare manifestation of obstructive jaundice due to a periampullary duodenal diverticulum in the absence of obstructing gallstones or masses. We present a case involving an 82-year-old woman admitted to the hospital with worsening abdominal pain, jaundice, and dark urine. Laboratory data showed hyperbilirubinemia, a cholestatic pattern of liver injury, leukocytosis, and elevated lipase levels. Magnetic resonance cholangiopancreatography revealed a large duodenal diverticulum, and findings of endoscopy further detailed duodenal mucosal inflammation consistent with acute diverticulitis leading to common bile duct and pancreatic outflow obstruction. She was successfully managed by endoscopic retrograde cholangiopancreatography with sphincterotomy and broad-spectrum antibiotic therapy.

Chronic Pulmonary Silicone Embolism Syndrome Following Saline Breast Implants | Annals of Internal Medicine: Clinical Cases

Chronic pulmonary silicone embolism syndrome (CPSE) presents as progressive dyspnea occurring after silicone prosthesis implantation. Diagnostic criteria for CPSE include imaging findings of intraparenchymal ground-glass opacities and histologic evidence of silicone microdroplets. CPSE is a very rare entity but has been reported previously secondary to ruptured silicone filled breast implants. Due to safety concerns, many plastic surgeons and patients consider saline-filled breast implants to be a sound alternative. Here, we report a middle-aged woman with biopsy-proven CPSE secondary to saline breast implants, nearly a decade after prosthesis removal.

Pallor of the Conjunctival Rim | Annals of Internal Medicine: Clinical Cases

A 76-year-old woman presented to the hospital with chronic melena. She was normotensive and tachycardic. Findings of a physical examination were notable for marked pallor of the conjunctival rim. She was found to have a hemoglobin of 3.4 g/dL.

A Rare Case of Doxycycline-Induced Autoimmune Hepatitis With Organizing Pneumonia | Annals of Internal Medicine: Clinical Cases

Autoimmune hepatitis and organizing pneumonia are uncommon, yet important, manifestations of drug toxicity. We describe the case of a 67-year-old woman who presented with shortness of breath shortly after completing a course of doxycycline and was incidentally found to have a prominent hepatitis. Subsequent evaluation yielded a diagnosis of doxycycline-induced autoimmune hepatitis and organizing pneumonia. This case gives credence to including drug-induced autoimmune hepatitis and organizing pneumonia in the differential for both liver injury and respiratory failure encountered in the setting of doxycycline exposure.

Succinate Dehydrogenase–Deficient Paraganglioma of the Prostate | Annals of Internal Medicine: Clinical Cases

Paragangliomas emerging in unusual locations may represent a diagnostic pitfall. We report clinical, genetic, imaging, and histopathologic features of succinate dehydrogenase–deficient paraganglioma arising within the prostate gland. This patient had multiple and recurrent paragangliomas since the age of 18 years. During the course of surveillance for a pathogenic germline SDHB variant, he developed 2 separate foci of disease in the prostate and retroperitoneum. Both lesions were gallium 68 DOTATATE positron emission tomography–avid and proved to be separate paragangliomas histologically. We emphasize that the prostate represents a site for paragangliomas, particularly in genetically predisposed patients who develop enlargement of the gland with normal prostatic-specific antigen.

Early Diagnosis to Prevent Carbon Monoxide Poisoning Complications | Annals of Internal Medicine: Clinical Cases

Carbon monoxide (CO) is a toxic gas with undetectable features. Every year in the United States, there are approximately 6000 deaths from CO poisoning. Patients usually present with signs of unresponsiveness but may have nonpathognomonic preceding symptoms. Some literature shows benefits of hyperbaric oxygen therapy (HBOT) within the first 24 hours of exposure to reduce the incidence of myocardial injury and neurologic impairment. This case report presents a 67-year-old man with CO poisoning who developed delayed neurologic sequelae (DNS) due to delayed diagnosis and missed therapeutic window for HBOT. Investigation of CO poisoning requires taking a detailed history to avoid delays in diagnosis and treatment.

ACP Pain Management: Back Pain: Get Your Patient Back in the Game

ACP Pain Management: Back Pain: Get Your Patient Back in the Game

ACP Pain Management: Osteoarthritis: What Works

ACP Pain Management: Osteoarthritis: What Works

ACP Pain Management: Back Cases

ACP Pain Management: Back Cases

ACP Pain Management: Knee Cases

ACP Pain Management: Knee Cases

ACP Pain Management Module 7: Opioid Use Disorder

ACP Pain Management Module 7: Opioid Use Disorder

ACP Pain Management Module 6: Opioid Therapy

ACP Pain Management Module 6: Opioid Therapy

ACP Pain Management Module 5: Non-Opioid Therapy

ACP Pain Management Module 5: Non-Opioid Therapy

ACP Pain Management Module 4: Non-Pharmacologic Therapy

ACP Pain Management Module 4: Non-Pharmacologic Therapy

ACP Pain Management Module 3: Pain Management Principles

ACP Pain Management Module 3: Pain Management Principles

ACP Pain Management Module 2: Pain Assessment

ACP Pain Management Module 2: Pain Assessment