Alcohol Consumption and Cardiovascular Health
The 2015 to 2025 Dietary Guidelines for Americans define moderate drinking as having up to one drink per day for women and up to two drinks per day for men.1 Alcohol consumption above the recommended limits was associated with higher all-cause and cause-specific mortality risk [39- 126%].2 Alcohol may contain polyphenols, amino acids, minerals,3 though the content varies considerably among types of alcohol (beer vs red wine vs white wine vs spirit). A complete understanding of these complex mechanisms in human health is limited. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - May 14, 2022 Category: General Medicine Authors: Chayakrit Krittanawong, Ameesh Isath, Robert S Rosenson, Muzamil Khawaja, Zhen Wang, Sonya E. Fogg, Salim S. Virani, Lu Qi, Yin Cao, Michelle T. Long, Christy C Tangney, Carl J Lavie Tags: Clinical Research Study Source Type: research

Intolerable unilateral hip pain: Clues from the history
There is no financial support or other benefits from commercial sources for the work reported on in the manuscript, or any other financial interests that any of the authors may have, which could create a potential conflict of interest or the appearance of a conflict of interest with regard to the work. Each of the authors has participated in the preparation of the manuscript. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - May 14, 2022 Category: General Medicine Authors: Jenice X. Cheah, Naziheh Assarzadegan, Jyotsna Ghosh, Caoilfhionn M. Connolly, Allan C. Gelber Tags: Clinical Communication to the Editor Source Type: research

Wilson Disease: Never Too Late . . .
A 43-year-old man presented with a 4-month history of abdominal bloating, loss of appetite and 5 kg weight loss. He was previously fit and well, with no history of alcohol or drug ingestion, and no prior blood transfusion. Clinical examination revealed pigmentation around the cornea of both eyes, consistent with Kayser-Fleischer (KF) rings (Figure A), but there were no other clinical features of chronic liver disease. On abdominal examination there was no organomegaly. He had no neurological deficits. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - May 13, 2022 Category: General Medicine Authors: Anand K. Annamalai, Venkatesh N. Prajna, Gunja Chowdhury, Radhakrishnan Santhi, Mariappan Kannan, Srinivasan Vedantham, Mark Gurnell Tags: Clinical Communication to the Editor Source Type: research

An Insight for Sore Eyes
A month into my second year of residency, I was diagnosed with an eye disease that required me to go on medical leave for months. As a physician, having a disease that precluded me from reading about my own health condition was both infuriating and eye-opening (though perhaps not in the way I had wanted at the time). (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - May 13, 2022 Category: General Medicine Authors: Lochan M. Shah Tags: Personomics Source Type: research

Wilson's disease – never too late
A 43-year-old man presented with a four-month history of abdominal bloating, loss of appetite and 5 kg weight loss. He was previously fit and well, with no history of alcohol or drug ingestion, and no prior blood transfusion. Clinical examination revealed pigmentation around the cornea of both eyes, consistent with Kayser-Fleischer (KF) rings (Fig. 1A), but there were no other clinical features of chronic liver disease. On abdominal examination there was no organomegaly. He had no neurological deficits. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - May 13, 2022 Category: General Medicine Authors: Anand K Annamalai, Venkatesh N Prajna, Gunja Chowdhury, Radhakrishnan Santhi, Mariappan Kannan, Srinivasan Vedantham, Mark Gurnell Tags: Clinical Communication to the Editor Source Type: research

Primary Medical Care Integrated with Healthy Eating and Healthy Moving is Essential to Reduce Chronic Kidney Disease Progression
Chronic kidney disease is among the few chronic diseases in the US with increasing prevalence 1, is the ninth leading cause of US mortality 2 and is increasing disability-adjusted life years lost 1, 3. Patients with chronic kidney disease contribute broadly to US mortality because they have increased risks for heart disease 4, cancer for those over age 65 years 5, and stroke 6 which represent, respectively, the first, second, and fifth causes of US mortality 2. Because patients with chronic kidney disease more likely die from these diseases before progressing to end-stage kidney disease 7, their deaths from these non-chron...
Source: The American Journal of Medicine - May 13, 2022 Category: General Medicine Authors: Donald E. Wesson, Vandana Mathur, Navdeep Tangri, Sarah Hamlett, David A. Bushinsky, L. Ebony Boulware Tags: Narrative Review Source Type: research

The Effect of Creative Arts Therapy on Psychological Distress in Healthcare Professionals
Healthcare professionals experience significant work-related psychological distress that has been exacerbated by the COVID-19 pandemic.1-4 This work-related psychological distress increases in settings that do not recognize the importance of creating healthy work environments, develop structures for peer support, or prioritize self-care and wellness. Even in supportive work settings, healthcare professionals may not share their own trauma and emotional experiences, and feel the need to process these events on their own. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - May 13, 2022 Category: General Medicine Authors: Marc Moss, Anthony Edelblute, Hillary Sinn, Kristen Torres, Jeri Forster, Tisha Adams, Courtney Morgan, Michael Henry, Katherine Reed Tags: Clinical Research Study Source Type: research

Malignant Pleural Effusion: Presentation, Diagnosis, and Management
Malignant pleural effusions are common in patients with cancer. Most malignant pleural effusions are secondary to metastases to the pleura, most often from lung or breast cancer. The presence of malignant effusion indicates advanced disease and poor survival; in lung cancer, the presence of malignant effusion upstages the cancer to stage 4. Usually presenting as a large, unilateral exudative effusion, most patients with malignant pleural effusion experience dyspnea. Prior to intervention, diagnosis of malignant pleural effusion and exclusion of infection should be made. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - May 13, 2022 Category: General Medicine Authors: Shameek Gayen Tags: Review Source Type: research

Murine Typhus Induced Myocarditis
We describe a case of murine typhus presenting as myocarditis in the setting of suspected acute coronary syndrome. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - May 13, 2022 Category: General Medicine Authors: Riya Madan, Varsha Muthukumar, Sarah Premji, Rujman Khan, R. Michelle Schmidt Tags: Clinical Communication to the Editor Source Type: research

An Unusual Case of Sarcoidosis: Hypercalcemia and Normal Sized Lymph Nodes
A 40-year-old man presented to the emergency department with a few days of nausea and vomiting, myalgias, and decreased oral intake. He was found to be hypotensive and hypercalcemic at 2.90 mmol/L with an albumin of 30 g/L. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - May 13, 2022 Category: General Medicine Authors: Melissa Wang, Lakshmi Puttangunta, Pen Li Tags: Diagnostic Dilemma Source Type: research

New Clinical Guidelines for the Diagnosis and Treatment of Heart Failure: Snatching Life from the Jaws of Death
Recently the American college of Cardiology, The American Heart Association and the Heart Failure Society of America reported on their newest guidelines for the diagnosis and treatment of patients with heart failure 1 (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - May 12, 2022 Category: General Medicine Authors: William H. Frishman, Joseph S. Alpert Tags: COMMENTARY Source Type: research

Safety and Efficacy of Thiazide Diuretics in Hypertension
More than 30 years ago the prospective, randomized Systolic Hypertension in the Elderly Program (SHEP) study documented that treatment with a thiazide, specifically chlorthalidone, substantially reduced outcome in elderly patients with isolated systolic hypertension.1 Treatment was associated with a 36% reduction in stroke in 4736 patients, and a reduction in major cardiovascular events, by 55 events per 1000 patients over 5 years. In view of the above and other prospective studies in aggregate, we are puzzled by the conclusions of Ravioli et al,2 that taking of a thiazide was the strongest independent predictor of falls a...
Source: The American Journal of Medicine - May 1, 2022 Category: General Medicine Authors: Franz H. Messerli, Stefano F. Rimoldi, Samuel J Mann Tags: Letter Source Type: research

Autonomic, Neurovascular Mechanisms in Migraine
To the Editor: (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - May 1, 2022 Category: General Medicine Authors: MJ Quinn Tags: Letter Source Type: research

Greater Good
I read Dr Alpert's commentary1 about lying to patients and remembered this story. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - May 1, 2022 Category: General Medicine Authors: Gabriel Marcelo Aisenberg Tags: Letter Source Type: research

The Reply
We thank Prof. Messerli and his co-authors for their letter concerning our recent publication on risks of electrolyte disorders, syncope, and falls in patients taking thiazide (-like) diuretics.1 (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - May 1, 2022 Category: General Medicine Authors: Gregor Lindner, Svenja Ravioli Tags: Letter Source Type: research