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Displaying 131 - 140 of 7509 in ACP Online

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.

Well-being Champion Curriculum

This self-paced learning series empowers you to lead meaningful change as a Well-being Champion by equipping you with leadership skills, evidence-based strategies, and practical tools to foster sustainable communities of well-being and professional fulfillment—right from where you are in your life and career.

Culture Change Interventions to Reduce Physician Burnout | ACP

Reduce physician burnout and improve well-being with these 10 culture change interventions. The American College of Physicians (ACP) is concerned about the health of internists and internal medicine and has compiled these interventions that can foster a culture of wellness and help physicians thrive.

Resources for Institutional Strategies to Promote Resilience and Reduce Burnout

These resources offer additional strategies to prevent burnout and promote well-being at the practice level.

Resident Well-being Learning Hub

ACP’s online Resident Well-being Learning Hub connects residents with evidence-based strategies to foster well-being and mitigate burnout and promote the value of collaborative learning environments and positive social interaction.

Positive Psychology in Times of Crisis

Kerri Palamara, MD, FACP, Director of the Center for Physician Well-being at Massachusetts General Hospital and Physician Coaching Services Lead for ACP, presents positive psychology strategies to use in a time of crisis. Dr. Palamara shares ideas from the coaching world including focusing on three good things, pausing to breathe, happiness boosters, sharing stories with colleagues, and more. Many of you are being asked to support the well-being of others right now.

Mastering the Art of Storytelling: A Leadership Technique to Engage, Inspire, and Influence

This activity equips physicians and healthcare leaders to enhance their leadership and communication through storytelling. With engaging videos, real-world examples, and a reflective workbook, participants will learn to craft impactful stories that build trust, inspire action, and support well-being in today’s complex healthcare environment.View the powerpoint

Draft Your Personal Mission Statement to Enhance Professional Fulfillment

Explore ways to define and use your unique mission statement to help guide your career and life decisions.

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Displaying 131 - 140 of 500 in Annals of Internal Medicine: Clinical Cases

Concomitant Exogenous Cushing Syndrome and Adrenal Insufficiency From Use and Withdrawal of the Supplement Ardosons | Annals of Internal Medicine: Clinical Cases

Unregulated supplements containing undisclosed glucocorticoids can cause exogenous Cushing syndrome and adrenal suppression on abrupt withdrawal. To our knowledge, we present the first known case of a patient using Ardosons for a decade, an over-the-counter arthritis supplement containing betamethasone leading to hypercortisolism. A 47-year-old man with ankylosing spondylitis developed Cushingoid features with subsequent adrenal insufficiency after abruptly stopping Ardosons. He was treated with hydrocortisone, leading to symptomatic improvement. Five weeks later, he had lost 7.3 kg, with reduced striae. Adrenal function remained suppressed 9 months after presentation. A thorough medication reconciliation is essential to identify hidden corticosteroids in patients with mixed Cushingoid and adrenal insufficiency symptoms.

Unraveling Pernicious Anemia With Severe Hemolysis and Roth Spots | Annals of Internal Medicine: Clinical Cases

A 47-year-old man who presented with sequential findings of Roth spots and severe hemolysis was found to have vitamin B12 deficiency due to pernicious anemia. His hematologic abnormalities were quickly corrected with vitamin B12 treatment. This case highlights nonimmune and hypoproliferative hemolysis due to intramedullary phagocytosis as a rare manifestation of vitamin B12 deficiency. It also brings anemic retinopathy, an easily overlooked pathology, to the attention of internists.

A Case Report of Anti–3-Hydroxy-3-Methylglutaryl-Coenzyme A Reductase Immune-Mediated Necrotizing Myopathy | Annals of Internal Medicine: Clinical Cases

We present a 75-year-old woman with 3 months of progressive proximal muscle weakness, myalgias, and dysphagia. Her admission was complicated by acute hypoxic respiratory failure requiring admission to the intensive care unit. Her clinical presentation and laboratory investigations were consistent with typical and atypical signs and symptoms of anti–3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) immune-mediated necrotizing myopathy (IMNM). Treatment with intravenous immunoglobulin, intravenous methylprednisolone, and oral methotrexate provided immediate relief of symptoms, further supporting the diagnosis of anti-HMGCR IMNM. We discuss the atypical presentations of anti-HMGCR IMNM and the complication of bulbar involvement leading to respiratory failure.

Latent Autoimmune Diabetes of Adults Due to Positive Zinc Transporter 8 Antibody | Annals of Internal Medicine: Clinical Cases

This case series reports 3 patients who were diagnosed with type 2 diabetes mellitus (T2DM), treated with oral antidiabetic medications, referred to our endocrinology clinic due to poor glycemic control, and were diagnosed with latent autoimmune diabetes of adults due to the isolated presence of ZnT8 antibody. Our cases highlight a few important learning points, such as maintaining a high degree of suspicion for the development of autoimmunity in a patient with T2DM with progressive or rapid worsening in glycemic control and the need to include the ZnT8 antibody in the panel of other diabetes antibodies during the work-up for autoimmune DM.

Intraocular Melanoma as an Initial Presentation of Birt–Hogg–Dubé Syndrome | Annals of Internal Medicine: Clinical Cases

Birt–Hogg–Dubé syndrome is a rare autosomal-dominant genodermatosis that affects approximately 2 in every 1 million people. A 68-year-old man presented to his yearly wellness visit with concerns of intermittent sensations and blurriness in his left eye, prompting referral to the ophthalmology department. Fundoscopic examination revealed an intraocular mass and a diagnosis of choroidal melanoma in the left eye was made. The patient received radiation therapy. The patient was referred to a geneticist, who detected a heterozygous germline pathogenic variant in FLCN: c.1389C>G (p.Tyr463*). It is important to incorporate a multidisciplinary approach, including a geneticist, to appropriately manage further work-up.

Cerebral Proliferative Arteriopathy Secondary to Extracranial Carotid Stenosis | Annals of Internal Medicine: Clinical Cases

Cerebral proliferative arteriopathy (CPA) is a rare vascular malformation distinct from arteriovenous malformations. Although arterial stenoses in CPA are thought to develop later, we hypothesize some cases may result from preexisting stenosis causing ischemia and vascular proliferation. A 7-year-old boy with a history of biliary atresia and a traumatic jugular line insertion presented with recurrent left hemiparesis. Magnetic resonance imaging and cerebral angiography revealed a pinhole stenosis in the right internal carotid artery and CPA features. This case suggests CPA may be a secondary maladaptive response to chronic ischemia in certain patients.

Ocrelizumab-Related Organizing Pneumonia: A Rare Pulmonary Complication in Multiple Sclerosis | Annals of Internal Medicine: Clinical Cases

We report a case of organizing pneumonia induced by ocrelizumab in a 65-year-old man with multiple sclerosis. The patient presented with persistent fever and progressive respiratory symptoms despite broad-spectrum antibiotic treatment. Chest imaging revealed diffuse ground-glass opacities, and a transbronchial biopsy confirmed organizing pneumonia. Corticosteroid therapy led to marked clinical improvement, and ocrelizumab was discontinued. This case highlights the importance of recognizing drug-induced organizing pneumonia in patients receiving immunomodulatory therapy, particularly when standard antibiotic treatments fail. Early identification and corticosteroid intervention are critical to avoid further complications.

Gallbladder Ascariasis After Acute Pancreatitis Due to Parasitic Migration | Annals of Internal Medicine: Clinical Cases

A 30-year-old woman presented with acute pancreatitis, initially showing gallstones and peripancreatic fluid on ultrasound. A follow-up ultrasound, after symptom persistence, revealed mobile, tubular hyperechoic structures in the gallbladder; biliary ascariasis was diagnosed. The appearance of Ascaris lumbricoides as a thick, echogenic structure without acoustic shadowing confirmed the parasitic migration. Treatment with albendazole resolved the symptoms within 72 hours. A subsequent ultrasound verified the absence of ascariasis, confirming the diagnosis and treatment success.

Concurrent Presentation of Posterior Reversible Encephalopathy Syndrome and Spontaneous Coronary Artery Dissection in a Postpartum Patient Without Traditional Risk Factors: A Case Report | Annals of Internal Medicine: Clinical Cases

Posterior reversible encephalopathy syndrome (PRES) and spontaneous coronary artery dissection (SCAD) are rare, life-threatening postpartum conditions, often linked to hypertensive disorders or hormonal changes. Their co-occurrence without traditional risk factors is exceptionally rare. We report a 29-year-old woman without hypertension who developed PRES and SCAD on postoperative day 1 after an uncomplicated cesarean delivery. She presented with altered mental status, seizure-like activity, and chest pain. Magnetic resonance imaging confirmed PRES, whereas coronary angiography identified SCAD. Management included the administration of levetiracetam for PRES and aspirin, beta-blockers, and an angiotensin-converting enzyme inhibitor for SCAD. This case highlights diagnostic challenges and the need for further research into shared mechanisms like endothelial dysfunction.

Cervical Paraspinal Pyomyositis Arising From Severe Allergic Contact Dermatitis to Hair Dye | Annals of Internal Medicine: Clinical Cases

A 70-year-old woman presented to the emergency department with painful posterior neck swelling and fever. Examination demonstrated a large, inflamed plaque across her posterior neck. Diagnostic evaluation revealed cervical paraspinal pyomyositis from methicillin-resistant Staphylococcus aureus as a likely complication of relative immunosuppression and significant excoriation from severe allergic contact dermatitis to p-phenylenediamine, a chemical found in hair dye. This case highlights the importance of considering pyomyositis as a potential diagnosis in patients presenting with painful muscle swelling and fever in the setting of significant skin abrasion and excoriation.

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Displaying 131 - 140 of 253 in ACP Store

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

ACP Pain Management Module 1: Pain Fundamentals

ACP Pain Management Module 1: Pain Fundamentals

Obesity Management 3: Metabolic and Bariatric Surgery

Obesity Management 3: Metabolic and Bariatric Surgery

Obesity Management 2: Pharmacotherapy

Obesity Management 2: Pharmacotherapy

Obesity Management 1: Lifestyle Modification

Obesity Management 1: Lifestyle Modification

Unisex I.M. Proud T-Shirts

Unisex I.M. Proud T-Shirts

Women's I.M. Proud Crew Neck T-Shirt

Women's I.M. Proud Crew Neck T-Shirt

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