November/December 2019


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Helping hands come from the community

Community health workers can help physicians and patients as part of a broader recognition that many factors that don't involve direct treatment can still drive medical outcomes.

New thinking about Alzheimer's diagnosis

New technology and biomarkers have contributed to the detection of Alzheimer's disease, but clinicians are skeptical about the value of a diagnosis without the ability to treat the condition.

Are internists team leaders or orchestra conductors?

Experience gained during residency training alongside so many other specialists and a role as care coordinators makes internal medicine specialists become uniquely qualified to serve as the conductor of this patient care orchestra.

It's hospital prices, stupid

Hospital prices are the largest contributor to overall health care spending, and lowering them would make health care more affordable.

Managing patients with diabetes and heart failure

Good control of diabetes in the presence of heart failure includes appropriate HbA1c targets, metformin and comprehensive lifestyle change as first-line therapy, and a team approach.

Diuretics demand discussion in heart failure management

To assess a patient's ability to adhere to a diuretic regimen, consider the patient's age, level of education, and severity of symptoms, as well as health literacy, and any comorbidities.

Understanding heart failure in African Americans

African Americans have a higher incidence of heart disease at a younger age, and they meet fewer criteria for ideal cardiovascular health, such as nonsmoking, physical activity, and lower body mass index.

Cluster headaches can hide in plain sight

Episodic cluster headaches and migraines are often confused, and more often than not, migraine is misdiagnosed as cluster.

An ode to Osler

The influential internist died 100 years ago this December.

Pulmonary illnesses linked to e-cigarette products

This column reviews details on recent recalls, warnings, and approvals.

Latest updates on ACP's priorities, initiatives

ACP Spotlight offers readers a look at ACP's current top priorities and initiatives, as well as highlights from our e-newsletter, ACP Internist Weekly.

MKSAP Quiz: 2-week history of difficulty swallowing

A 67-year-old man is evaluated in the emergency department with a 3-day history of weakness and nausea and a 2-week history of difficulty swallowing. He has lost 22.7 kg (50 lb) during the past year. He has no other symptoms. History is significant for a 30-pack-year history of smoking. Following a physical exam, lab studies, and chest CT, what is the most likely diagnosis?

Look to the community to bolster patient care

This issue also covers Alzheimer's disease, conference coverage from the Heart Failure Society of America, and whether heart failure is different in African-American patients

Nominees named for College Officer and Regent positions

The Governance Committee of the American College of Physicians places in nomination candidates for College governance.