In the News

U.S. Surgeon General Vivek H. Murthy ‘03 Discusses the Loneliness Epidemic by Yale School of Management Vital relationships are the foundation of success and happiness in communities, and in the workplace, Murthy told Yale SOM students during the semester's first Leaders Forum lecture on September 8. Read here

From the Trenches

Power of Connectivity Initiative by Kerri Palamara, MD, MACP Implement Your Own Initiative

ACP Multimedia Education

Game Plan Refresh Series for Trained WBCs Marion McCrary, MD, FACP, and NC Well-being Champion (WBC), revisits strategies learned during your WBC training and new skills to grow your toolkit to support you and your colleagues. Managing Challenging Interactions and Compassion (Self and Others) Watch Video

May 19, 2023

Nurturing Connections Through ACP Resources

Professional Fulfillment Zone

Recap of the Internal Medicine Meeting held in Boston, MA, April 18-20, 2024The Career and Professional Development Center in the Exhibit Hall was a one-stop shop for networking, Physician Peer Coaching, Mini But Mighty Skills sessions, and recharging in the Well-being Fun Zone.

Patients Before Paperwork

Advocacy in Action New ACP Leadership Shares Dedication to Strengthening the Voice of Physicians Dr. Isaac O. Opole, new ACP President, and Dr. William E. Fox, new Chair of the ACP Board of Regents, both credit involvement in ACP for their professional success.

Noteworthy Resources For Well-being

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

In the News

The Biden-Harris Administration, through the U.S. Department of Health and Human Services (HHS), just released the 2024 National Strategy for Suicide Prevention and accompanying Federal Action Plan. Watch the HHS Secretary explain in 90 seconds this groundbreaking new initiative and how YOU can help. "Suicide is a complex public health problem, tragically impacting our friends, family members, neighbors and community members nationwide," said HHS Secretary Xavier Becerra.

From the Trenches

Learn the importance of: "Being There" From Travis Hoover, MD, resident physician in radiation oncology at the University of Maryland Read here! "How Do Our Minds Help (or Hinder) Finding Connection & Purpose?" From the latest episode of Surgeon General Dr. Vivek Murthy's House Calls podcast

May 17, 2024

Effect of a Structured Exercise Program on the Overall Burden of Major Mobility Disability Among Older Adults

Acupuncture With Electrical Stimulation as a Treatment for Severe Chronic Constipation

Variation in Assessments of Breast Density on Mammograms in Clinical Practice

Assessing the Risk for Diabetes in Patients With Unexpectedly Identified Tumors in the Adrenal Glands

Special Shoes for the Management of Knee Osteoarthritis Symptoms

Pioglitazone for Patients With Nonalcoholic Steatohepatitis and Prediabetes or Type 2 Diabetes

Tai Chi Versus Physical Therapy for Knee Osteoarthritis

Management of Chronic Insomnia Disorder in Adults: A Clinical Practice Guideline From the American College of Physicians

Aspirin Use for the Primary Prevention of Cardiovascular Disease and Colorectal Cancer: Recommendations From the U.S. Preventive Services Task Force

Trying to Quit Cigarette Smoking by Cutting Down or Stopping Abruptly

Once-weekly semaglutide reduced problematic alcohol use, small study shows

Ticagrelor monotherapy associated with less bleeding risk than dual antiplatelet therapy

And the winner is …

Article, podcast discuss navigating AI in health care

Registration is open for ACP's live, virtual POCUS Mentorship Program

Less sleep may be associated with hypertension risk

MKSAP Quiz: Medication after STEMI

Vestibular suppressants associated with higher fall risk in dizzy patients

NOACs, aspirin carry similar risks of major bleeding, intracranial hemorrhage

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Likelihood of ED boarding varies by race, insurance type | ACP Hospitalist

Alteplase effective up to 24 hours after stroke onset, Chinese trial finds | ACP Hospitalist

ACC issues guidance on diagnosis, management of pericarditis | ACP Hospitalist

Academic hospitalists: Time to redefine or fade away | ACP Hospitalist

Urinalysis-based cutoff reduced UTI antibiotic use, nudges and decision support did not | ACP Hospitalist

Take a quiz about the July 30 issue! | ACP Hospitalist

Say, do you remember? | ACP Hospitalist

Platelet parsimony | ACP Hospitalist

New hospitalist hires mostly come from residency, onboarding poses challenges | ACP Hospitalist

Naloxone, opioid coprescribing increased with clinical decision support tool | ACP Hospitalist

Methotrexate-Associated Lymphoproliferative Disorder With Gingival Swelling | Annals of Internal Medicine: Clinical Cases

A 63-year-old Japanese man being treated for pemphigus vulgaris with methotrexate (MTX) presented with a fever of unknown origin. His only symptom at onset was mild gingival swelling. Suspected to have gingivitis, he was followed for 1 month. After that, he presented with cervical lymphadenopathy, dysphagia, and bicytopenia, and a diagnosis of MTX-associated lymphoproliferative disorder (MTX-LPD) was finally made by gingival biopsy. He had spontaneous remission after the withdrawal of MTX. When MTX-treated patients complain of fever and oral lesions, even if the oral lesions present as mild gingival swellings, physicians should consider MTX-LPD and perform a diagnostic biopsy.

High Radial Nerve Palsy Resulting From Massage | Annals of Internal Medicine: Clinical Cases

Nerve palsies can lead to devastating outcomes that frighten patients. The limited availability in the published literature of information regarding nerve palsies can be disconcerting to patients and primary care physicians alike. This case report identifies this mechanism of injury and follows the path of recovery. A high radial nerve palsy resulting from a deep tissue massage about the shoulder recovered in 6 to 8 weeks. With the apparent increase of massage parlors in our society, the frequency of such events may increase. By providing references regarding such injuries, clinicians can better reassure patients as to expected outcomes.

Listeria monocytogenes–Associated Acute Cholecystitis: A Case Report and Review of the Literature | Annals of Internal Medicine: Clinical Cases

People who are pregnant, immunocompromised, or elderly are at risk for listeriosis, a life-threatening condition. Although Listeria monocytogenes may be asymptomatic or limited to uncomplicated gastroenteritis in healthy adults, it can cause invasive disease such as meningitis and bacteremia in susceptible individuals. Less commonly, L monocytogenes can cause a focal site of infection such as acute cholecystitis. In the literature, previous cases of L monocytogenes–associated acute cholecystitis were treated with antibiotics either provided or held and a cholecystectomy. We present an 80-year-old man who recovered from acute cholecystitis due to L monocytogenes with appropriate antibiotic coverage and a percutaneous cholecystostomy.

Three Cases of Atypical Cutaneous Ovarian Metastases: A Single-Center Case Series | Annals of Internal Medicine: Clinical Cases

Ovarian cancer rarely metastasizes to the skin, but when cutaneous metastases occur, the typical location is within the umbilicus, commonly known as a Sister Mary Joseph nodule. Extraabdominal cutaneous metastases from ovarian cancer are extremely rare. Here, we report a series of 3 patient cases at a single institution who presented with extraabdominal cutaneous ovarian metastases. We discuss the potential mechanisms for cutaneous involvement as well as histopathology, treatments, and outcomes in patients with extraabdominal cutaneous ovarian cancer metastases.

Rosai-Dorfman Disease Presenting as Massive Mediastinal Lymphadenopathy in an Elderly Man | Annals of Internal Medicine: Clinical Cases

We present a patient case of a 73-year-old man with new-onset substernal chest pain and B symptoms, found on computed tomography imaging to have massive mediastinal lymphadenopathy of more than 6 cm. Positron emission tomography imaging revealed fluorodeoxyglucose-avid nodes further extending to the axillary, abdominal, and inguinal regions. After a broad patient work-up for infectious, malignant, and rheumatic causes, he was ultimately diagnosed with Rosai-Dorfman disease, a rare histiocytic neoplasm, by excisional lymph node biopsy.

Physical Examination Manifestations of Aortic Insufficiency | Annals of Internal Medicine: Clinical Cases

The eponyms of aortic regurgitation are well recognized, yet their diagnostic accuracy remains poor. Nevertheless, they remain part of the medical nomenclature, highlight the importance of the physical examination, and provide a historical lens to a disease in the age before more modern technology.

Skeletal Fluorosis: “Huffing” of Inhalant Computer Cleaning Fluid | Annals of Internal Medicine: Clinical Cases

Skeletal fluorosis is a disorder characterized by the deposition of fluoride within the bones. It is a rare presentation in the United States since the administration of sodium fluoride for the treatment of osteoporosis was discontinued several years ago. We report an adult woman manifesting skeletal fluorosis involving both axial and appendicular bones secondary to “huffing” (inhalation) of various commercial electronic cleaning products containing 1,1 difluoroethane. It is important to be alert to the presence of this disorder in patients abusing inhalants to prevent bone deformities, fragility fractures, and consequential morbidities.

Hepatic Encephalopathy in Osler-Weber-Rendu Syndrome | Annals of Internal Medicine: Clinical Cases

Hereditary hemorrhagic telangiectasia or Osler-Weber-Rendu syndrome is a rare condition that leads to multiple vascular malformations. We describe the interesting patient case of a woman with recurrent epistaxis secondary to Osler-Weber-Rendu syndrome, who presented with confusion, and was ultimately found to have a hepatic arteriovenous malformation leading to hepatic encephalopathy. Computed tomography angiography images are provided, which highlight the extensive hepatic arterioportal shunting that caused elevated serum ammonia levels in the setting of gastrointestinal breakdown of blood products.

Systemic Immunoglobulin Light Chain Amyloidosis Presenting as Painful Penile Ulcers | Annals of Internal Medicine: Clinical Cases

Immunoglobulin light chain (AL) amyloidosis is a systemic form of amyloidosis that commonly affects the heart, kidney, liver, and nervous system. Penile involvement in AL amyloidosis is rare and thus often not considered in the differential diagnosis for penile ulcers. We report a case of an elderly man with nonhealing, painful penile ulcers who had AL amyloidosis with cardiac, renal, and liver involvement. His penile lesions were successfully treated with surgical resection of the amyloid deposits. Even after serologic relapse of his systemic amyloidosis, he has not had recurrence of his penile ulcers many years later.

Hypoglossal Nerve Palsy Due to a Sublingual Space Abscess | Annals of Internal Medicine: Clinical Cases

We report an unusual case of a hypoglossal nerve palsy secondary to a sublingual space abscess in a previously fit and healthy 59-year-old man. The patient presented with fever, dysphagia, trismus, and a left-sided tongue and floor-of-mouth swelling with left hypoglossal nerve palsy. Computed tomography (CT) scan revealed a 3.5-cm abscess of the left sublingual space. The abscess drained spontaneously while awaiting surgery with resolution of symptoms. Urgent investigation with CT is recommended for every deep neck space infection. Hypoglossal nerve palsy is a rare sign that warrants further investigation to exclude malignancy.