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Thoracoabdominal Aneurysm in a Professional Body Builder

To the Editor: A 33-year-old otherwise healthy man presented with worsening epigastric and flank pain for 3 weeks. He denied having vomiting, diarrhea, fever, urinary symptoms, or history of kidney stones. His vital signs were significant for a blood pressure of 140/72 mm Hg and pulse rate of 94 beats/min. Acute coronary syndrome was excluded by electrocardiography. A […]

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Scurvy, a Not-So-Ancient Disease

A 65-year-old man with a history of alcohol and tobacco use and few medical interactions presented with 1 week of progressive dyspnea. Examination revealed a cachectic man with large areas of nonpainful ecchymoses on the posterior thighs (Figure). Additional skin findings included spider angiomata on the face and chest, scattered bruising on upper extremities, and […]

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The Frequency of Unnecessary Testing in Hospitalized Patients

Testing is an important part of medicine across all specialties and settings. As a result, the volume of testing is enormous, with an estimated 4-5 billion tests performed in the United States each year.1 Unnecessary laboratory testing and diagnostic imaging is believed to be common. Studies looking at testing of patients have found 40%-60% of tests […]

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How Pure is PURE? Dietary Lessons Learned and Not Learned From the PURE Trials

The Prospective Urban Rural Epidemiology (PURE) cohort studies add a new level of understanding of some key environmental components of health.1 The population is diverse, and represents individuals from various socioeconomic levels with a long period of follow-up. The dietary macronutrient analysis of this cohort conducted by the study group2 has yielded interesting findings, undoubtedly warranting additional […]

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The Deficit of Nutrition Education of Physicians

Globally, death rates from cardiovascular disease are increasing, rising 41% between 1990 and 2013, and are often attributed, at least in part, to poor diet quality. With urbanization, economic development, and mass marketing, global dietary patterns have become more Westernized to include more sugar-sweetened beverages, highly processed foods, animal-based foods, and fewer fruits and vegetables, […]

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