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- ACP Online (7611)
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Displaying 321 - 330 of 7611 in ACP Online
Patients Before Paperwork
Celebrate Mental Health Awareness Every Day by George Lyons Jr., Esq. Recognizing mental health entails the individual acknowledging it and seeking help, society not stigmatizing those suffering from mental and behavioral disorders, and the nation providing adequate resources and personnel to address the problem.
Noteworthy Resources
Mentoring Matters: The Art and Science of Mentoring Webinar Mentors play an integral role in the professional development of their mentees. Join Mitchell D. Feldman, MD, MPhil, FACP, as he explores the key characteristics and competencies of an effective mentor and describes how to support alignment in mentoring relationships. Learn strategies to analyze and optimize mentoring relationships to include activities of sponsorship. This webinar is open to ACP members. There will be time for questions after the presentation.
In the News
Inclusivity That Never Dies: The Future of ACP by George M. Abraham, MD, MPH, MACP ACP's President recaps his tenure as he discusses the College's efforts at diversity, equity, and inclusion.
From the Trenches
Opportunities to Connect:Topic: Small Feedings of the Soul: Readings and Reflections Series
May 20, 2022
Promoting Mental Health Awareness and Well-being Strategies That Support Whole-System ThrivingIf 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 Distress Hotline (800-985-5990).
Patients Before Paperwork
ACP Offers Recommendations for Using Performance Measures in Telemedicine Settings In a new policy paper, ACP recommends that performance measures evaluating telemedicine visits adhere to the same criteria as in-person visits. View here! ACP Calls for Changes to Prior Authorization System That Prioritize Patients and Physicians CMS is working to streamline the process and proposes a reduction in the amount of time physicians need to wait for decisions on requests from payers.
Noteworthy Resources
Well-being Champion Training: Growth After Trauma & Nurturing Well-being In this recorded session, Dr. Kerri Palamara rounds out all of the learnings from your Well-being Champion training through exercises that facilitate tangible action in navigating and implementing positive individual, community, and organizational change and prioritize clinician well-being in a constantly shifting landscape. View here!
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
Displaying 321 - 330 of 6848 in Annals of Internal Medicine
These Annals of Internal Medicine results only contain recent articles.
- Visit annals.org to search all content back to 1927.
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The Effect of Heat Exposure on Myocardial Blood Flow and Cardiovascular Function
Background: Heat extremes are associated with greater risk for cardiovascular death. The pathophysiologic mechanisms mediating this association are unknown. Objective: To quantify the myocardial blood flow (MBF) requirements of heat exposure. Design: Experimental study. (ClinicalTrials.gov: NCT04549974) Setting: Laboratory-based. Participants: 61 participants, comprising 20 healthy young adults (mean age, 28 years), 21 healthy older adults (mean age, 67 years), and 20 older adults with coronary artery disease (CAD) (mean age, 70 years). Intervention: Participants were heated until their core temperature increased 1.5 °C; MBF was measured before heat exposure and at every increase of 0.5 °C in core temperature. Measurements: The primary outcome was MBF measured by positron emission tomography–computed tomography. Secondary outcomes included heart rate, blood pressure, and body weight change. Results: At a core temperature increase of 1.5 °C, MBF increased in healthy young adults (change, 0.8 mL/min/g [95% CI, 0.5 to 1.0 mL/min/g]), healthy older adults (change, 0.7 mL/min/g [CI, 0.5 to 0.9 mL/min/g]), and older adults with CAD (change, 0.6 mL/min/g [CI, 0.3 to 0.8 mL/min/g]). This represented a 2.08-fold (CI, 1.75- to 2.41-fold), 1.79-fold (CI, 1.59- to 1.98-fold), and 1.64-fold (CI, 1.41- to 1.87-fold) change, respectively, from preexposure values. Imaging evidence of asymptomatic heat-induced myocardial ischemia was seen in 7 adults with CAD (35%) in post hoc analyses. Limitations: In this laboratory-based study, heating was limited to about 100 minutes and participants were restricted in movement and fluid intake. Participants refrained from strenuous exercise and smoking; stopped alcohol and caffeine intake; and withheld β-blockers, calcium-channel blockers, and nitroglycerin before heating. Conclusion: Heat exposure that increases core temperature by 1.5 °C nearly doubles MBF. Changes in MBF did not differ by age or presence of CAD, but some older adults with CAD may experience asymptomatic myocardial ischemia. Primary Funding Source: Canadian Institutes of Health Research.
Displaying 321 - 330 of 3144 in IM Matters
Displaying 321 - 330 of 2393 in ACP Hospitalist
Displaying 321 - 330 of 500 in Annals of Internal Medicine: Clinical Cases
An Unusual Cause of Acute Abdominal Pain: A Case Report and Review of the Diagnostic Reasoning | Annals of Internal Medicine: Clinical Cases
Spontaneous bladder rupture is a rare cause of acute abdominal pain. This case report reviews the clinical presentation of a patient with this unusual disorder and discusses the steps that the clinician used to reach the diagnosis. The concept of how clinicians use problem representations and illness scripts to arrive at a differential diagnosis, and ultimately a diagnosis, is discussed.
Pancreatic-Pleural Fistula in a Patient With Recurrent Pancreatitis and Unknown Pancreatic Divisum | Annals of Internal Medicine: Clinical Cases
Recurrent acute pancreatitis (RAP) affects less than 1% of the population and can rarely be associated with severe extra-abdominal complications. We herein present a case of RAP due to a congenital anomaly with a rare thoracic complication that was undiagnosed by classic imaging method to highlight a unique presentation of an uncommon clinical entity.
Metastatic Lobular Carcinoma of the Breast Masquerading as Gallstone Disease – A Case Report | Annals of Internal Medicine: Clinical Cases
The gallbladder is a rare site of breast cancer metastasis. We report the patient case of a 60-year-old woman with isolated metastasis to the gallbladder, which was surgically removed for symptomatic cholelithiasis, with a subsequent new diagnosis of infiltrating lobular carcinoma (ILC) of the breast. ILC tends to metastasize to unusual sites such as the gastrointestinal and genitourinary tracts, but these usually occur concurrently with other more common sites of distant metastasis such as the bone, lungs, and liver. Our case underscores the need for routine histologic examination of gallbladder after cholecystectomy.
Diffuse Alveolar Hemorrhage as an Unusual Pulmonary Manifestation of Multisystem Inflammatory Syndrome in Adults | Annals of Internal Medicine: Clinical Cases
Multisystem inflammatory syndrome–A (MIS-A) is a rare postacute complication of COVID-19 infection in adults. It is a hyperinflammatory condition presenting as cardiogenic and vasogenic shock leading to multiorgan failure. Diffuse alveolar hemorrhage (DAH) is a rare pulmonary condition, with diverse etiologies ultimately leading to the extravasation of red blood cells into alveoli, resulting in respiratory compromise. The association between MIS-A and DAH has not been reported in the literature. Here, we describe a case of a 33-year-old man who presents with shock and diffuse alveolar hemorrhage in the setting of a highly inflammatory state, consistent with MIS-A.
Massive Splenomegaly | Annals of Internal Medicine: Clinical Cases
Massive splenomegaly, defined as length spleen greater than 20 cm, is a relatively rare entity with a broad differential. Primary splenomegaly occurs in the setting of leukemias and lymphomas, whereas secondary splenomegaly is more common and carries a broad differential. We present a case of massive splenomegaly with an approach to differential diagnoses and brief discussion of splenic marginal zone lymphoma.
Point-of-Care Ultrasound: An Emerging Tool for Diagnosing Calciphylaxis | Annals of Internal Medicine: Clinical Cases
Calciphylaxis is a disease involving medial calcification of dermal arterioles, resulting in cutaneous necrosis. Diagnosis is typically clinical, but it is frequently misdiagnosed. Skin biopsy, the gold standard diagnostic test, is hindered by risk, patient refusal, and difficulties with histologic evaluation. This case series investigates using soft tissue point-of-care-ultrasound (POCUS) to aid in diagnosis. It describes ultrasound images obtained from patients diagnosed with calciphylaxis. These potentially pathognomonic sonographic findings in the proper clinical context include superficial hyperechoic foci lining small-caliber vessels with posterior acoustic shadowing. This demonstrates the diagnostic potential of POCUS in evaluating patients with possible calciphylaxis.
A Case of DILI and Subsequent HLH Induced by Allopurinol | Annals of Internal Medicine: Clinical Cases
Hemophagocytic lymphohistiocytosis (HLH) is a syndrome that occurs because of uncontrolled immune cell activation and can present as a primary or acquired disorder. It is an illness with a high mortality rate that has been increasing in incidence over the past decade. There are few reports of allopurinol-induced HLH. This case describes a patient who was initially diagnosed with drug-induced liver injury secondary to allopurinol and subsequently diagnosed with HLH secondary to allopurinol. The discussion highlights the pathophysiology, clinical findings, diagnostic work-up, and treatment of HLH, along with mentioning interventions that focus on prevention of these diseases.
Multiple Organ Dysfunction Syndrome Secondary to Multiple Wasp Stings: A Case Report | Annals of Internal Medicine: Clinical Cases
Wasp sting is common in resource-limited countries like Viet Nam. Symptoms can range from mild (itching, urticaria, and angioedema) to severe (multiorgan dysfunction), which increases mortality. Rhabdomyolysis and acute respiratory distress syndrome are rare complications but yield a high risk of death, thus requiring emergent interventions. We present a case of a 32-year-old man suffering from multiple wasp stings. The patient manifested several swollen, erythematous, and tender stings, and then developed a high fever, dyspnea, and reddish urine. He was diagnosed with multiple organ dysfunction syndrome, including severe hemolysis, acute kidney injury, liver injury, and acute respiratory distress syndrome.
Primary Cardiac Angiosarcoma: Pericardial Erosion and Disseminated Metastasis in a Young Active Duty Man | Annals of Internal Medicine: Clinical Cases
Primary cardiac tumors are exceedingly rare with a reported prevalence of 0.0017% to 0.028%. Seventy-five percent of these tumors are benign. Of the primary malignant tumors, the most common are sarcomas. Primary cardiac sarcomas are often rapidly progressive and carry a very poor prognosis because of distant metastasis, erosion within the heart, and the development of circulatory obstruction. We describe an unfortunate case of primary cardiac angiosarcoma leading to the death of an otherwise healthy young man.
Disseminated Cutaneous Herpes Simplex Virus: A Severe Case of Erythema Herpeticum in a Clinically Immunocompetent Patient | Annals of Internal Medicine: Clinical Cases
Herpes simplex virus (HSV)–induced eczema herperticum is seen in clinical practice most commonly as lesions of the mucosa or epidermis. Disseminated cutaneous infection caused by HSV-1 is rarely reported. Here, we present the patient case of a woman in her late 20s who came in for a presumed eczema flare that quickly developed into a disseminated cutaneous disease. Skin biopsy revealed HSV-1 as the causative factor. Valacyclovir therapy led to almost complete resolution of her skin lesions.