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Displaying 291 - 300 of 7611 in ACP Online

Patients Before Paperwork

Physician Well-being Call to Action Advocacy Toolkit: Modernize License and Credentialing Applications to Not Stigmatize Mental Health View Here! Ask Your Legislators to Expand Physician Workforce, Improve Patient Access, Promote Health Equity and Reduce Burden View Here!

Noteworthy Resources

Physician Suicide Prevention and the Ethics and Role of a Healing Community: An American College of Physicians Policy Paper Matthew DeCamp, MD, PhD, and Mark Levine, MD, for the ACP Ethics, Professionalism and Human Rights Committee

In the News

Protective Equipment for Physicians' Mental Health By Mollie Frost ACP Internist

From the Trenches

After a Physician Dies by Suicide By Ryan DuBosar ACP Internist This article shares resources and discusses the multiple factors that contribute to physician death by suicide. Highlighted tools include advocating for systems changes, destigmatizing mental health help-seeking in the culture of medicine, and creating supportive communities for those associated with or affected by the tragic event. View here!

ACP Multimedia Education

Know Your Colleagues, Know Yourself: Checking In on Mental HealthLiz Lawrence, MD, FACP

September 15, 2023

Individual and Systems Resources That Give Agency and Provide Nurturing Safe Spaces and Supportive CommunitiesIf you or someone you know is in crisis, help is available 24/7. Text 741741 or call the National Suicide Prevention Lifeline (988 or 1-800-273-8255) or Disaster Disress Hotline (1-800-985-5990).

Professional Fulfillment Zone

Celebrating Over 5 Years of ACP Well-being Champions!In September, we held a special event that celebrated the history of ACP's Well-being Champion Program.

Patients Before Paperwork

Advocacy in ActionThese are scary times for public healthBy Shari M. Erickson, MPH, for I.M. Matters from ACPActions taken by leadership at the Department of Health and Human Services are creating confusion and slowly killing off the science and research that public health depends on.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

Well-being Interventions for Rural Health Professionals: A Scoping ReviewThe Journal of Rural Health: Skye McKennon, PharmD, BCPS, ACSM-GEI; Suzanne Fricke, DVM, MLIS; Dawn DeWitt, MDMSc, CMedEd, MACP, FRACP, FRCP-LondonThe objective of this scoping review is to identify interventions to promote well-being that have been tried or proven effective to prevent or address burnout in rural health care professionals and trainees (HCPTs). Secondarily, we aimed to identify potentially applicable and feasible well-being interventions that could help rural HCPTs.

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Displaying 291 - 300 of 500 in Annals of Internal Medicine: Clinical Cases

Cutaneous Scrotal Metastasis Secondary to Primary Prostate Adenocarcinoma Responding to Immunotherapy | Annals of Internal Medicine: Clinical Cases

This case demonstrates the aggressive progression of prostate adenocarcinoma, failing 3 treatment regimens. Although the patient initially responded to treatments, he developed cutaneous metastasis. Genomic tumor analysis of scrotal tissue confirmed targetable molecular mutations. Treatment with systemic immunotherapy was initiated with complete resolution of disease. This case reveals the rare metastasis of prostate adenocarcinoma to the scrotum with advanced refractory cancer and the successful response to immunotherapy. It illustrates the importance of tumor genomic testing in advanced refractory prostate cancer.

Lymphomatoid Granulomatosis Presents With Nodal and Bone Marrow Invasion: A Case Report and Literature Review | Annals of Internal Medicine: Clinical Cases

Lymphomatoid granulomatosis (LYG) is a rare lymphoproliferative disease driven by Epstein-Barr virus (EBV) infection. It is characterized by pulmonary involvement; however, nodal and bone marrow invasion are very rare. Tissue biopsy is the cornerstone of diagnosis. To our knowledge, this is the first case of LYG presenting with nodal, spleen, and bone marrow invasion on initial work-up. Imaging suggested nodal and marrow site invasion along with classical lung lesions. Biopsy and immunoprofile confirmed EBV+ B-cell lymphoma, which is diagnostic of LYG grade 3. The patient responded to chemotherapy for this high-grade disease.

Multisystem Inflammatory Syndrome After Mild COVID-19 Infection in a Fully Vaccinated Adult | Annals of Internal Medicine: Clinical Cases

Multisystem inflammatory syndrome in adults (MIS-A) is a rare and severe complication of SARS-CoV-2 infection that is more common in children than adults. It is often underdiagnosed by physicians because of the heterogeneity of symptoms, overlapping comorbid conditions, and a lack of comprehensive work-up. Here, we present a patient case of MIS-A after mild COVID-19 infection in a fully vaccinated adult. The goal of this case is to describe the presentation of MIS-A in adults and review the associated laboratory results that can guide early diagnosis and management to improve outcomes.

An Immunocompromised Adult With Oral Ulcers | Annals of Internal Medicine: Clinical Cases

Infection with Histoplasma capsulatum has a broad spectrum of clinical manifestations, ranging from asymptomatic, subclinical infection in the immunocompetent host to severe, disseminated disease in the immunocompromised host. We report a case of disseminated histoplasmosis with oral mucocutaneous manifestations in a patient with advanced HIV/AIDS and poor antiretroviral adherence. We also discuss key aspects in the diagnosis and management of disseminated histoplasmosis in patients with HIV/AIDS.

Dermatomyositis Presenting as Pseudo-angioedema | Annals of Internal Medicine: Clinical Cases

Dermatomyositis is an autoimmune inflammatory myopathy that has a heterogeneous clinical presentation, which can make it difficult to diagnose. We present the first case report of Wong-type dermatomyositis presenting with pseudo-angioedema. A 65-year-old man presented with several months of facial swelling, dysphagia, and dysarthria. The patient developed a diffuse cutaneous rash, periorbital swelling, and proximal muscle weakness. Skin biopsy was consistent with a diagnosis of Wong-type dermatomyositis.

Iatrogenic Hyperkalemia Induced by Hypermagnesemia From Administration of Laxatives in a Patient With Gastroparesis | Annals of Internal Medicine: Clinical Cases

Magnesium-containing drugs such as magnesium citrate are popular over-the-counter laxatives used to treat constipation. Although generally well tolerated, excessive intake can result in potentially dangerous electrolyte abnormalities. Of these abnormalities, hyperkalemia is one that is heavily underreported. We report an elderly woman who presented for gastroparesis flare-up and constipation. She was given magnesium citrate and subsequently developed hypermagnesemia, which resulted in hyperkalemia. By presenting this case, we hope to increase awareness of this heavily underreported side effect of magnesium-based laxatives, especially in the setting of gastrointestinal disturbances that may affect the absorption of these electrolytes.

Uphill and Downhill Esophageal Varices Secondary to Pulmonary Hypertension | Annals of Internal Medicine: Clinical Cases

Downhill esophageal varices (EVs) are rare endoscopic findings and coincide with superior vena cava (SVC) obstruction. Historically, downhill EVs have been associated with malignancy, thrombosis, or iatrogenic SVC obstruction. Few cases of “benign obstruction”, as in pulmonary hypertension (PH) with tricuspid regurgitation (TR), have been reported. Downhill EV can result in life-threatening bleeds; however, there are no current guidelines regarding treatment or surveillance endoscopy. We report a case of both uphill and downhill EV due to benign obstruction from PH and TR, leading to the diagnosis of decompensated cirrhosis.

A Rare Cause of Severe Hypoglycemia in Intracranial Hemangiopericytoma Associated With Non-Islet Cell Tumor Hypoglycemia | Annals of Internal Medicine: Clinical Cases

A 60-year-old man with a history of metastatic intracranial hemangiopericytoma and type 2 diabetes mellitus presented with acute episodes of confusion and dizziness. A magnetic resonance imaging scan of the brain showed progressing calvarial metastasis without intracranial abnormality. He was found to have severe persistent hypoglycemia. The initial hypoglycemia work-up revealed low serum insulin and C-peptide level and negative panel for oral hypoglycemic agents. Further laboratory testing revealed an elevated insulin-like growth factor II (IGF II):IGF-I ratio and low β-hydroxybutyrate, consistent with nonislet cell tumor hypoglycemia. The patient received prednisone and his hypoglycemia improved.

Pancreatic Acinar Cell Carcinoma in the Setting of a BRCA1 Germline Mutation | Annals of Internal Medicine: Clinical Cases

Pancreatic acinar cell carcinoma (PACC) is a rare neoplasm of the exocrine pancreas. PACC’s molecular and genetic features are poorly elucidated compared with pancreatic ductal cell carcinoma. Here, we present the patient case of a woman in her late 60s, with a BRCA1 germline mutation and a medical history of breast and lung adenocarcinomas diagnosed with PACC. A literature search identified only 2 reported cases of PACC associated with a BRCA1 germline mutation.

Milk Alkali Syndrome Complicated by Calcium Impaction Causing Bowel Perforation | Annals of Internal Medicine: Clinical Cases

The milk-alkali syndrome consists of hypercalcemia, metabolic alkalosis, and acute kidney injury associated with the ingestion of large amounts of calcium and absorbable alkali. There has been a resurgence of this condition because of calcium therapy for prevention and treatment of osteoporosis, easy access to over-the-counter calcium carbonate preparations, and use of calcium carbonate to minimize secondary hyperparathyroidism in patients with chronic kidney disease. We report a rare patient case of severe milk-alkali syndrome resulting in hemodynamic instability and multiple metabolic derangements with severe intestinal obstruction in the setting of fecal impaction.

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