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Pursuing the diagnosis of low back pain
Pursuing the diagnosis of low back pain
Low back pain is an extremely common reason for patients to seek medical evaluation. It has been estimated that approximat...
Low back pain: Spondylitis?
Low back pain: Spondylitis?
A 37-year-old woman was referred to the rheumatology clinic due to symptoms concerning for spondylitis. She had noted wors...
Should an NPO order be placed for my patient with acute pancreatitis?
Should an NPO order be placed for my patient with acute pancreatitis?
A 45-year-old man with a 10-year history of alcohol use disorder presents to the emergency department with constant severe...
A hidden cause of hypokalemia
A hidden cause of hypokalemia
A 21-year-old-man presented to the emergency department with increasing fatigue and psychosis symptoms. He had experienced...
Diabetes technology: A primer for clinicians
Diabetes technology: A primer for clinicians
ABSTRACTDiabetes technology is evolving rapidly and is changing the way both patients and clinicians approach the manageme...
Gastroparesis for the nongastroenterologist
Gastroparesis for the nongastroenterologist
ABSTRACTGastroparesis is a heterogeneous motility disorder characterized by nausea, vomiting, and postprandial fullness. I...
Preexposure prophylaxis for preventing HIV infection: Routine practice in primary care
Preexposure prophylaxis for preventing HIV infection: Routine practice in primary care
ABSTRACTAn estimated 1.2 million people in the United States have human immunodeficiency virus (HIV) infection per US Cent...
New CCJM faces and features
New CCJM faces and features
Spring is the poetic time for rejuvenation, and we at the Journal, going with the poetic flow, welcome 2 new deputy editor...
Gingival overgrowth in acute monocytic leukemia
Gingival overgrowth in acute monocytic leukemia
A 55-year-old man presented to the emergency department with a 2-month history of progressive gingival swelling and oral p...
Providing comfort: Caring for patients who wish to die in their home country
Providing comfort: Caring for patients who wish to die in their home country
In an increasingly global world, medical teams must be adept at caring for patients who have immigrated. This includes res...
Perspectives on travel and healthcare
Perspectives on travel and healthcare
Travel for healthcare has been fueled in recent years by a range of factors. These include innovations in treatment as wel...
Should I refer my patient for a parathyroidectomy?
Should I refer my patient for a parathyroidectomy?
A 60-year-old woman who is otherwise healthy is found to have an elevated serum calcium level of 10.5 mg/dL (reference ran...
Do I always need a central venous catheter to administer vasopressors?
Do I always need a central venous catheter to administer vasopressors?
Vasopressors are the cornerstone of treatment for shock, and a central venous (CV) catheter is generally preferred for the...
Does every patient with lactational mastitis require antibiotic treatment?
Does every patient with lactational mastitis require antibiotic treatment?
My 4-week-postpartum lactating patient calls into clinic with a complaint of 12 hours of a tender, hot, swollen breast. Be...
Functional dyspepsia: How to manage the burn and the bloat
Functional dyspepsia: How to manage the burn and the bloat
ABSTRACTFunctional dyspepsia is defined as persistent symptoms of postprandial bloating, early satiety, or pain in the cen...
Reducing the risks when using benzodiazepines to treat insomnia: A public health approach
Reducing the risks when using benzodiazepines to treat insomnia: A public health approach
ABSTRACTBenzodiazepines are widely used but can cause considerable harm, including sedation, addiction, falls, fractures, ...
Simultaneous hemorrhage and venous thrombosis in a patient with systemic lupus erythematosus
Simultaneous hemorrhage and venous thrombosis in a patient with systemic lupus erythematosus
A 40-year-old white woman with systemic lupus erythematosus (SLE), reported positive lupus anticoagulant, and avascular ne...
Corticosteroids: Giving and taking away
Corticosteroids: Giving and taking away
In Dickensian terms, corticosteroids are the best of drugs and the worst of drugs. As I often tell patients, we will both ...
In Reply: When should we consider SGLT-2 inhibitors in patients with acute decompensated heart failure?
In Reply: When should we consider SGLT-2 inhibitors in patients with acute decompensated heart failure?
We thank Dr. Sharma for the valuable contribution and concur with the opinion about optimal timing of initiating SGLT-2 in...
Acquired reactive perforating collagenosis in a patient with diabetes
Acquired reactive perforating collagenosis in a patient with diabetes
A 47-year-old woman presented with a 2-month history of pruritic eruptions on the left ankle and a complaint of thirst and...
Microscopic colitis: What is it, and what are the treatment options?
Microscopic colitis: What is it, and what are the treatment options?
Microscopic colitis, an inflammatory disorder characterized by chronic diarrhea, is so named because its diagnosis require...
Severe hyponatremia: Are you monitoring the urine output?
Severe hyponatremia: Are you monitoring the urine output?
A 52-year-old woman was brought to the emergency department by her friend because she was concerned about the woman’s new ...
When should I give corticosteroids to my patient with Pneumocystis pneumonia?
When should I give corticosteroids to my patient with Pneumocystis pneumonia?
Nonpregnant adult patients with human immunodeficiency virus (HIV) and Pneumocystis jirovecii (formerly carinii) pneumonia...
Nonhormone therapies for vasomotor symptom management
Nonhormone therapies for vasomotor symptom management
Vasomotor symptoms (VMS), more commonly known as hot flushes or flashes and night sweats, are the cardinal symptoms of men...
Management of lower-extremity venous thromboembolism: An updated review
Management of lower-extremity venous thromboembolism: An updated review
ABSTRACTAccording to the 2021 updated guidelines of the American College of Chest Physicians, the location of venous throm...
Glucocorticoid-induced adrenal insufficiency and glucocorticoid withdrawal syndrome: Two sides of the same coin
Glucocorticoid-induced adrenal insufficiency and glucocorticoid withdrawal syndrome: Two sides of the same coin
ABSTRACTDiseases of the adrenal glands can lead to primary adrenal insufficiency, and suppression of the hypothalamic-pitu...
A tale of scale: Corticosteroids and pustular psoriasis
A tale of scale: Corticosteroids and pustular psoriasis
In this issue of the Journal, Wong and colleagues1 describe a severe episode of generalized pustular psoriasis (GPP) in a ...
In Reply: 2023 Update in ambulatory general internal medicine
In Reply: 2023 Update in ambulatory general internal medicine
We appreciate Ashley Lim’s close read of our review. Regarding the use of SGLT-2 inhibitors in patients without albuminuri...
Steroid use triggers severe psoriatic reaction
Steroid use triggers severe psoriatic reaction
A 69-year-old man with well-controlled plaque psoriasis who presented to the emergency department for unilateral wrist pai...
Is there a role for chronic suppressive therapy in herpes simplex virus infection?
Is there a role for chronic suppressive therapy in herpes simplex virus infection?
Yes. The primary role of chronic suppressive therapy in herpes simplex virus (HSV) infection is to decrease the frequency,...