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Displaying 181 - 190 of 7509 in ACP Online

Professional Fulfillment Zone

Announcing ACP Internal Medicine Meeting 2025 Well-being Poster WinnersCongratulations to this year's poster winners in the Physician Well-being and Professional Fulfillment category!

Patients Before Paperwork

Advocacy in ActionVaccines effective, and controversial, since their inventionBy Jason M. Goldman, MD, MACP, for I.M. Matters from ACPThe amount of vaccine misinformation and disinformation in recent years has truly been astounding, ACP's President says.Read here

Noteworthy Resources for Well-being

ACP: Design Your Own Well-being ProgramExplore these tools to create a well-being program tailored to any organization's needs and budget.View here!

In the News

September Is Suicide Prevention Awareness MonthThere are many ways to take action, start a conversation, and raise awareness for Suicide Prevention. You can:

From the Trenches

Physician Coaching by Professionally Trained Peers for Burnout and Well-BeingJAMA Network Open: S.B. Kiser, MD, MPH; J.D. Sterns, MD, MPH; P.Y. Lai, MS; Nora K. Horick, MS; K. Palamara, MD

September 19, 2025

ACP Well-being Champions: Promoting Well-being Through Awareness, Advocacy, and Action“Loneliness does not come from having no people about one, but from being unable to communicate t

Patients Before Paperwork

Patients Before Paperwork Update: On August 3, 2020 the Centers for Medicare & Medicaid Services (CMS) issued its Physician Fee Schedule and Quality Payment Program proposed rule. A number of the proposals are aimed at reducing administrative burden, especially in the telehealth services space.

Noteworthy Resources

Stigma Compounds the Consequences of Clinician Burnout During COVID-19: A Call to Action to Break the Culture of Silence By Jennifer B. Feist, J. Corey Feist, and Pamela Cipriano

New ACP Webinars

Well-being Champion Webinar: Feelings and Needs Kerri Palamara, MD, FACP Tuesday, September 22, 2020, 2:00–3:00 p.m. ET

In the News

“It's Time to Stop Stigmatizing Mental Health Among Healthcare Workers” By Jessica Gold, Forbes This summer, physicians took to Twitter to discuss their own mental health struggles and treatment in hopes that transparency will help break the stigma of mental illness and seeking help, and ultimately change the culture of medicine.

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Displaying 181 - 190 of 500 in Annals of Internal Medicine: Clinical Cases

When Cold Meets Hemolysis: A Unique Case of Paroxysmal Cold Hemoglobinuria in an Adult | Annals of Internal Medicine: Clinical Cases

Paroxysmal cold hemoglobinuria (PCH) is a rare autoimmune hemolytic anemia, historically linked to syphilis and mainly seen in children. We report a case in a young adult during fall, following a recent upper respiratory infection. Common infectious triggers were ruled out and imaging showed no masses. The patient presented with severe anemia (hemoglobin level, 3.6 g/dL) and received steroids, 2 rituximab infusions, and 9 units of packed red blood cells. His symptoms improved and he was discharged after 12 days on oral steroids with stable hemoglobin. This case highlights the importance of recognizing atypical adult presentations of PCH.

Precision in Crisis: A Case Study on the Diagnostic Pitfalls in Acute Aortic Dissection | Annals of Internal Medicine: Clinical Cases

We report the case of a young man with a history of abdominal aortic aneurysm repair who presented with acute chest pain. An initial work-up included a computed tomography (CT) pulmonary angiogram, which ruled out pulmonary embolism but did not reveal an aortic dissection. Subsequent transthoracic echocardiography and gated CT angiography confirmed an acute Stanford type A aortic dissection. This case highlights the importance of considering aortic dissection in differential diagnoses and the limitations of CT pulmonary angiography in detecting aortic abnormalities.

A Probable Rickettsial Trigger for Hemophagocytic Lymphohistiocytosis: Murine Typhus | Annals of Internal Medicine: Clinical Cases

Hemophagocytic lymphohistiocytosis (HLH) is a serious hyperinflammatory condition with hyperactive cytotoxic T cells and macrophages that can be triggered by various infections, malignancies, and rheumatologic conditions. Herein, we present a rare case of secondary HLH due to probable murine typhus. A 65-year-old man presented with generalized weakness, anemia, thrombocytopenia, and elevated liver enzymes. Evaluation revealed extremely elevated ferritin and presence of hemophagocytosis on bone marrow aspirate. He was initially treated with dexamethasone and etoposide for suspected HLH, but additional evaluation confirmed typhus group positivity. With initiation of doxycycline, the patient's clinical condition rapidly improved.

A Case of Primary Cardiac Myeloid Sarcoma in the Absence of Lymphoproliferative and Myeloproliferative Disorders | Annals of Internal Medicine: Clinical Cases

Myeloid sarcoma is a rare extramedullary malignancy that is strongly associated with acute myelogenous leukemia and infrequently arises from cardiac tissue. We present a unusual case of primary isolated cardiac myeloid sarcoma identified in the absence of lymphoproliferative and myeloproliferative disorders. Tumors of unknown origin can pose a major diagnostic dilemma in patients with atypical clinical presentations. Noninvasive multimodal imaging was used to identify the mass, evaluate potential diagnoses, anticipate complications, provide surveillance, and determine potential surgical interventions. This case demonstrates the appropriate diagnostic evaluation of patients presenting with a cardiac mass and the indications for endomyocardial biopsy.

Unmasking the Hidden: A Rare Case of Miliary Lung Adenocarcinoma With Pneumothorax Mimicking Tuberculosis | Annals of Internal Medicine: Clinical Cases

This report details a rare case of a man with advanced primary lung adenocarcinoma who presented with miliary metastasis and pneumothorax that closely mimicked the clinical and radiologic features of miliary tuberculosis. The overlapping characteristics posed significant diagnostic challenges, highlighting the need for a thorough differential diagnosis in similar presentations to ensure accurate and timely treatment.

Bilateral Iliac Vein Compression From Hugged Iliac Arteries: An Uncommon Variant of May-Thurner Syndrome | Annals of Internal Medicine: Clinical Cases

May-Thurner syndrome is a rare clinical entity with compression of the iliocaval anatomical unit by the overlying arteries against the underlying bone, resulting in venous insufficiency. Patients present with leg swelling, redness, varicosities, and deep venous thrombosis. We present a case of bilateral May-Thurner syndrome where the patient was noted to have external compression of both iliac veins from the external and internal iliac arteries wrapped around the iliac veins, an extremely rare anatomical finding, causing more than 90% stenosis of the bilateral iliac veins. The patient had bilateral stent placement with significant improvement in symptoms and a gradual reduction in leg swelling and pain.

A Case of Sudden Onset of Hypersomnolence | Annals of Internal Medicine: Clinical Cases

We report a case of a 59-year-old woman who presented with a sudden onset of severe hypersomnolence. Imaging confirmed acute bithalamic infarcts. Bithalamic strokes pose diagnostic challenges, especially during the emergent and acute phase, owing to their unique clinical presentation as patients may lack focal deficit, potentially leading to a delay in diagnosis and treatment. We outline the acute and chronic clinical course and discuss the emerging neuropsychiatric sequelae.

Treatment of Paraganglioma With Transcatheter Arterial Chemoembolization: A Case Report | Annals of Internal Medicine: Clinical Cases

A 57-year-old man presented with intermittent abdominal pain. Computed tomography scan of the abdomen revealed a large retroperitoneal mass containing a rich blood supply that surrounded the abdominal aorta. Furthermore, the patient's serum catecholamine levels were increased substantially. Findings of needle biopsy of the abdominal mass were consistent with paraganglioma. Attempted surgical resection of the mass yielded an unsatisfactory result. The man then underwent successful transcatheter arterial chemoembolization with eradication of the paraganglioma. This case highlights the application of transcatheter arterial chemoembolization as an approach for the management of paragangliomas.

Progressive Acro-Osteolysis of the Fingers | Annals of Internal Medicine: Clinical Cases

A 63-year-old woman with systemic sclerosis (SSc) exhibited progression of bone resorption in the distal phalanges (acro-osteolysis). This case underscores the importance of adequately managing Raynaud phenomenon, as it alone can drive the progression of acro-osteolysis in patients with long-standing SSc.

False-Positive HIV Testing in a Chimeric Antigen Receptor T-Cell Recipient: A Case Report | Annals of Internal Medicine: Clinical Cases

Chimeric antigen receptor T (CAR T) cell therapy has transformed the treatment of hematologic malignancies, and its use is rapidly expanding in other areas as well. Many currently available CAR T cells use a lentiviral vector derived from HIV-1, which can then lead to false -positive HIV tests in CAR T recipients. We present a case report and review of literature of this phenomenon. As increasing numbers of patients receive CAR T-cell therapy, awareness of the potential for false-positive HIV testing is critical for providing care to these patients.

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