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Balancing the myths of corticosteroid therapy
Balancing the myths of corticosteroid therapy
No class of drug has more mythical attributes, interfaces with different medical specialties, or clinical street lore than...
Widespread skin-thickening and hyperpigmentation
Widespread skin-thickening and hyperpigmentation
A 37-year-old white male presented with skin-thickening and hyperpigmentation, the onset of which correlated with an incre...
Phenytoin-induced gingival overgrowth
Phenytoin-induced gingival overgrowth
A 27-year-old man presented to our neurosurgery clinic with a 3-month history of lower-extremity weakness and slurred spee...
Mucinous ascites: Pseudomyxoma peritonei
Mucinous ascites: Pseudomyxoma peritonei
A 59-year-old man with a history of hypertension presented with 2 months of progressive abdominal distention associated wi...
Nasal herpes simplex virus infection
Nasal herpes simplex virus infection
A 37-year-old man with epilepsy presented to the emergency department with a 1-week history of skin changes of the nose th...
Diversifying medical humanities: The case for Jay-Z
Diversifying medical humanities: The case for Jay-Z
The underpinnings of medicine are based in science, but its practice—like all human endeavors—is bound up in history, soci...
Hyperpigmentation as a clue to Addison disease
Hyperpigmentation as a clue to Addison disease
A 66-year-old woman presented to our department with generalized fatigue and loss of appetite.A review of her medical reco...
Primary and secondary prevention of atherosclerotic cardiovascular disease: A case-based approach
Primary and secondary prevention of atherosclerotic cardiovascular disease: A case-based approach
ABSTRACTEstimating the risk of atherosclerotic cardiovascular disease (ASCVD) is a daily challenge for clinicians and is c...
Steroids in the acutely ill: Evolving recommendations and practice
Steroids in the acutely ill: Evolving recommendations and practice
ABSTRACTCritical illness-related corticosteroid insufficiency (CIRCI) is a state of systemic inflammation involving dysreg...
Cirrhotic coagulopathy: A rebalanced hemostasis
Cirrhotic coagulopathy: A rebalanced hemostasis
ABSTRACTCirrhosis has been regarded as a hypocoagulable state associated with an increased risk of bleeding. But patients ...
An unexpected turn
An unexpected turn
In the July 2022 issue, an error appeared in Ganeshan S, Kelemen B, Dhaliwal G, Zier L. An unexpected turn: A 71-year-old ...
Circulating lipids are not all bad: An LDL mimic that may be only skin deep
Circulating lipids are not all bad: An LDL mimic that may be only skin deep
Mai and Akhondi1 in this issue of the Journal present photographs from a single patient with 4 distinct skin findings usua...
Xanthomas: Differentiating atherogenic from nonatherogenic
Xanthomas: Differentiating atherogenic from nonatherogenic
A 42-year-old woman with a known history of primary biliary cholangitis, a chronic progressive cholestatic autoimmune live...
The double-tongue sign
The double-tongue sign
An 85-year-old woman with stage 3 chronic kidney disease presented to our hospital with dyspnea and intermittent mild feve...
Is exercise restriction necessary in patients with pericarditis?
Is exercise restriction necessary in patients with pericarditis?
A 47-year-old woman presents with recurrent episodes of pleuritic chest pain. She is physically active and exercises 5 tim...
What are the considerations in patient selection and timing of risk-reducing mastectomy?
What are the considerations in patient selection and timing of risk-reducing mastectomy?
In patients with pathogenic or likely pathogenic genetic variants in high-risk genes (BRCA1, BRCA2, PALB2, PTEN, TP53, and...
Do all patients with primary pulmonary coccidioidomycosis need antifungal therapy?
Do all patients with primary pulmonary coccidioidomycosis need antifungal therapy?
No. Patients diagnosed with primary pulmonary coccidioidomycosis (PPC) who are asymptomatic or mildly symptomatic do not r...
Altered mental status in a man with metabolic syndrome
Altered mental status in a man with metabolic syndrome
A 29-year-old man was found by his father to be unresponsive with shallow breathing and foaming at the mouth. The man’s fa...
The role of GLP-1 receptor agonists in managing type 2 diabetes
The role of GLP-1 receptor agonists in managing type 2 diabetes
ABSTRACTGlucagon-like peptide-1 (GLP-1) receptor agonists improve glycemic control in patients with type 2 diabetes mellit...
Unilateral atrophic kidney in a 45-year-old woman
Unilateral atrophic kidney in a 45-year-old woman
A 45-year-old woman with a history of hypertension and ischemic stroke at age 26 presented to the emergency department wit...
Nontuberculous mycobacterial musculoskeletal infections: Recognizable, when suspected
Nontuberculous mycobacterial musculoskeletal infections: Recognizable, when suspected
In this issue of the Journal, we have 2 Clinical Picture articles1,2 portray and emphasize a shared clinical theme. Both d...
Dactylitis from Mycobacterium intracellulare infection
Dactylitis from Mycobacterium intracellulare infection
A 69-year-old man was referred to our hospital with a 6-month history of progressive swelling in the right middle finger w...
Which ICU patients need stress ulcer prophylaxis?
Which ICU patients need stress ulcer prophylaxis?
ABSTRACTCritically ill patients are at an increased risk for developing stress ulcers of the mucosa of the upper gastroint...
Unraveling a challenging diagnosis: Role of a TNF inhibitor
Unraveling a challenging diagnosis: Role of a TNF inhibitor
A 48-year-old male industrial electrician presented for consultation with a 5-year history of pain and swelling of the dor...
Mondor disease of the breast
Mondor disease of the breast
A 43-year-old woman presented to the outpatient breast clinic with a 2-week history of pain and skin tightness over the ri...
Acute anxiety and tachycardia in a hospitalized 59-year-old woman
Acute anxiety and tachycardia in a hospitalized 59-year-old woman
A 59-year-old woman was hospitalized after 3 days of neck pain, painful swallowing, headache, and fever. Three years earli...
Womens health update: A literature review impacting primary care
Womens health update: A literature review impacting primary care
ABSTRACTThe authors review studies on key issues in women’s health with potential impact on internal medicine practice. Th...
An unexpected turn: A 71-year-old man with myocardial infarction
An unexpected turn: A 71-year-old man with myocardial infarction
A 71-year-old man who had been previously well was brought to the emergency department by ambulance after experiencing sev...
Metastatic bone disease: Early referral for multidisciplinary care
Metastatic bone disease: Early referral for multidisciplinary care
ABSTRACTIt is estimated that more than half of all cancers develop bony metastases, exacting a substantial cost in terms o...
A clinical trial and another clinical practice bites the dust, or should there not be an appendix?
A clinical trial and another clinical practice bites the dust, or should there not be an appendix?
There are clinical directives that I recall reiterated in multiple settings from medical school onwards. On medical school...