Noteworthy Resources

Chapter Collaborations (ACP LeaderNet Access Required) This resource is to assist you in working with your chapter's leadership to reflect on where your chapter is, where it would like to elevate to, and how a strategic collaboration could help you achieve that vision.

In the News

Addressing Patient Bias Toward Health Care Workers: Recommendations for Medical CentersBy Kimani Paul-Emile, JD, PhD; Jeffrey M. Critchfield, MD; Margaret Wheeler, MS, MD; Shalila de Bourmont, BS; and Alicia Fernandez, MDThis article offers guidance to organizations on devising effective policies that meet the needs of medical centers, patients, and health care workers across services and roles, including physicians, nurses, and trainees.

From the Trenches

Congratulations! ACP Award for Outstanding Contributions to Improving Well-being and Professional Fulfillment in Internal Medicine Mukta Panda, MD, MACP Chattanooga, Tennessee WBC Emeritus

ACP Multimedia Education

Well-being Champion Training: Data This module explains gathering and analyzing well-being data, followed by discussion and example interventions you can consider. View Here (Must be logged in to ACP Online to access.)

November 17, 2023

Professional Fulfillment Zone

Want to take your WBC training to the next level?

Patients Before Paperwork

Advocacy in Action ACP Updates Its Climate Change and Health Toolkit The American College of Physicians is renewing its call to members to help mitigate the effects of climate change and educate others on how to do the same. Click below to download the toolkit. View here!

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

Biden-Harris Administration Announces Nearly $100 Million to Grow the Health Workforce U.S. Department of Health and Human Services: September 17, 2024

From the Trenches

Learn the Importance of Sharing Stories of Vulnerability to Shift the Culture in Medicine: “Stories and Statistics” Annals of Internal Medicine: by Marya J. Cohen, MD, MPH Read about how Dr. Cohen's personal story helped her understand the impact of using stories over numbers to convey meaning behind medicine. Read here! “What Do I Need Today?” With Kerri Palamara, MD, MACP

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

Physical Fitness During Adolescence and Long-Term Risk for Type 2 Diabetes Mellitus

Oral Prednisolone in the Treatment of Acute Gout

Medicine and Nonmedicine Options for the Treatment of Adults With Major Depressive Disorder

Appropriate Antibiotic Use for Acute Respiratory Tract Infection in Adults: Advice for High-Value Care From the American College of Physicians and the Centers for Disease Control and Prevention

Mechanical Symptoms and Arthroscopic Partial Meniscectomy in Patients With Degenerative Meniscus Tear

Hematuria as a Marker of Occult Urinary Tract Cancer

Screening for Depression in Children and Adolescents: U.S. Preventive Services Task Force Recommendation Statement

Screening for Breast Cancer: Recommendations From the U.S. Preventive Services Task Force

Call for fall 2025 Board of Governors resolutions

Health care costs lower for patients with diabetes in years after bariatric surgery vs. before

MKSAP Quiz: Follow-up for osteoporosis

NT-proBNP thresholds insufficient to diagnose HF in ambulatory patients with chronic dyspnea

Supine hypertension worrisome, measuring BP in noisy environment can be acceptable, accurate

Put words in our mouth

Registration open for Clinical Skills Center's hands-on learning opportunities

Report outlines alcohol's health effects, seeks public comment

MKSAP Quiz: Evaluation for exertional dyspnea

Antivirals have little to no effect on nonsevere influenza, review indicates

Boarding in the ED on the rise before, worsened during pandemic, study finds | ACP Hospitalist

Take a quiz about the May 28 issue! | ACP Hospitalist

Tackling transfers | ACP Hospitalist

New guidelines on platelet transfusions support restrictive strategies for many patients | ACP Hospitalist

Hybrid HaH model found to be safe alternative to traditional inpatient care | ACP Hospitalist

High inpatient mortality rate, disparities in incidence with candidemia in recent years | ACP Hospitalist

Cognitive outcomes similar between perioperative blood pressure strategies | ACP Hospitalist

Body of evidence | ACP Hospitalist

Take a quiz about the May 21 issue! | ACP Hospitalist

No difference in time to extubation with propofol, dexmedetomidine, or clonidine | ACP Hospitalist

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.

A Young Man With Recurrent Syncope | Annals of Internal Medicine: Clinical Cases

A 35-year-old man presented with recurrent syncope. On examination, wooly hair and palmoplantar hyperkeratosis were seen. Cardiac magnetic resonance imaging showed late gadolinium enhancement, and a genetic test ultimately confirmed the diagnosis of Carvajal syndrome.

Purple Urine Bag Syndrome: “Treated” and Untreated | Annals of Internal Medicine: Clinical Cases

An elderly man with chronic constipation presented with purple urine.

Prostate Adenocarcinoma With Atypical Immunohistochemistry Presenting With a Cheerio Sign | Annals of Internal Medicine: Clinical Cases

The most common cancer in men is prostate cancer. The Cheerio sign is the computed tomography finding of multiple pulmonary nodules with central lucency resembling the ring-shaped Cheerio breakfast cereal. Unlike bone metastasis, pulmonary involvement is less common. The Cheerio sign has malignant and benign etiologies. Thyroid transcription factor-1 (TTF-1) stain is commonly used in the diagnosis of primary lung cancer. TTF-1 positivity in cancers of prostate origin is rare, with only case reports and small case series available in the literature. Metastatic prostate cancer presenting with a Cheerio sign has not been reported in the literature.

“Trench Foot” on the Banks of Lake Geneva: A Severe Case of Nonfreezing Cold Injury | Annals of Internal Medicine: Clinical Cases

Formerly known as “trench foot” or “immersion foot,” nonfreezing cold injury (NFCI) is a rare condition mainly seen among vulnerable groups. We report the case of a homeless male diagnosed with NFCI after having spent 2 days in rainy, cold weather. He presented with white, wrinkled feet and sensorimotor loss. Imaging revealed thrombosis of the leg arteries. No revascularization procedure was possible, and the patient developed soft tissue necrosis requiring bilateral transtibial amputation. Our case highlights the high morbidity linked with NFCI and the need for early recognition and treatment by medical health professionals along with the implementation of preventive measures.

Management of Acute Episodes of Clarkson Disease (Monoclonal Gammopathy-Associated Systemic Capillary Leak Syndrome) With Intravenous Immunoglobulins | Annals of Internal Medicine: Clinical Cases

Monoclonal gammopathy-associated idiopathic systemic capillary leak syndrome (ISCLS, Clarkson disease) is a rare disorder defined by transient but recurrent bouts of hypotensive shock and anasarca resulting from plasma extravasation. Although prophylactic treatment with high-dose intravenous immunoglobulins (IVIG, 1–2 g/kg/mo) prevents most disease flares, its utility for acute episodes of ISCLS is unclear. Here, we report the results of a retrospective study of subjects with acute ISCLS treated at or near the onset of symptoms with IVIG. We found that administration of IVIG with minimal additional intravenous fluids was safe and associated with rapid clinical improvement. IVIG given close to the onset of ISCLS-related symptoms is associated with a favorable outcome.

Fecal Transplant Sustained Colitis Remission on Immunotherapy Resumption | Annals of Internal Medicine: Clinical Cases

Immune checkpoint inhibitors are increasingly used to treat various cancers, but they can cause immune-related adverse events that lead to treatment cessation. Here we report 2 cases of immune-mediated colitis that were treated with fecal microbiota transplant. Both cases had sustained colitis remission, which allowed resumption of immunotherapy.

A Rare Case of Paraneoplastic Dermatomyositis in a Patient With Metastatic Endometrial Cancer | Annals of Internal Medicine: Clinical Cases

Dermatomyositis (DM) is a rare autoimmune myopathy that presents with muscle weakness and characteristic skin manifestations. Certain malignancies are associated with DM, such as stomach, colorectal, ovarian, lung, pancreatic, and non-Hodgkin lymphoma. However, there are only rare reports of endometrial cancer with DM. In this report, we describe a case of anti–TIF-1-gamma and anti-Mi-2 antibody positive DM in a patient with stage IV endometrial cancer. This case illustrates the importance of considering DM as a paraneoplastic syndrome regardless of both stage and type of malignancy.

Giant Cell Tumor in Axial Skeleton With Neurologic Symptoms | Annals of Internal Medicine: Clinical Cases

A healthy 34-year-old man exhibited progressive lower-extremity numbness and weakness. Computed tomography revealed a mass compressing the thoracic spine with associated pathologic fracture. Biopsy showed findings compatible with giant cell tumor of the bone, and H3F3A gene mutation testing confirmed the diagnosis present in the axial skeleton. He was successfully managed with T3–T7 fusion, T5 corpectomy, and physical therapy. This case highlights an atypical presentation of an uncommon neoplasm with associated neurologic deficits.