Posts in Internal Medicine

A female doctor and an older male patient reviewing a PSA screening report together at a wooden desk.

Reading the PSA Trend, Not the Number: A Smarter Approach to Prostate Screening

Key Takeaways: June is Men’s Health Month, and PSA screening — the prostate-specific antigen blood test — remains the most argued-about topic in primary care.[…]

A glowing anatomical heart with intricate, illuminated capillary networks in red and amber tones.

When the Arteries Look Clean: Microvascular Angina and Ischemia With No Obstructive Coronary Disease

Patients sometimes present with classic exertional chest pain, abnormal stress testing, or even troponin-positive events, and then return from coronary angiography with the news that[…]

A woman stands beside a cluttered desk near a window, resting her hand on a closed laptop and taking a deep breath with her eyes closed.

The Tax of Always-On Stress: Allostatic Load and the Cardiovascular Cost of Never Recovering

Allostasis is the physiologic process by which the body changes set points to meet acute demand — heart rate rises during a sprint, blood pressure[…]

A smartwatch displaying a heart rate graph of 74 BPM resting on a wooden desk next to a ceramic mug of tea.

The Watch That Catches the Quiver: Smartwatch Detection of Atrial Fibrillation and Stroke Prevention

Atrial fibrillation is the most common sustained cardiac arrhythmia in adults, and its central clinical danger is silent. When the atria fibrillate, coordinated mechanical contraction[…]

3D visualization of a DNA double helix with intensely glowing, fiery caps on both ends.

The Caps on Your Chromosomes: Telomere Biology, Stress, and the Exercise That Lengthens Them

At each end of every chromosome lies a repeating DNA sequence called a telomere. The repeats themselves carry no protein code; their job is structural.[…]

A woman peacefully sleeping on a couch covered by a thick knit blanket, with a book and water bottle resting beside her.

The Long Tail of a Virus: Autonomic Dysfunction and Mitochondrial Recovery

The clinical pattern is familiar to any primary care physician who has seen patients in the years following the COVID-19 pandemic. A previously healthy adult[…]

A square overhead photo of a leafy green salad with sliced raw beets and walnuts.

The Velocity of Aging: Pulse Wave Velocity and Arterial Stiffness

Pulse wave velocity is the speed at which a pressure pulse generated by left ventricular ejection travels along the arterial tree. Measured noninvasively by tonometry[…]

Abstract medical illustration of red blood cells flowing smoothly through a healthy artery.

The Forgotten Lining: How the Endothelial Glycocalyx Protects Your Arteries

The endothelium, the single-cell-thick lining of every blood vessel in the body, is not a smooth, sterile pipe. It is coated with a delicate, hair-like[…]

Overhead view of a colorful bowl with salmon, berries, leafy greens, walnuts, quinoa, avocado, cucumber, broccoli, and seeds on a linen napkin.

The Inflammatory Subtype of Depression: When Cytokines Cross the Blood-Brain Barrier

May is Mental Health Awareness Month, and a quietly transformative finding from the last fifteen years of psychiatric research is that depression is not a[…]

Abstract view inside an artery with plaque narrowing one side and red blood cells flowing through a clearer open channel.

From Stable to Reversible: The Mechanics of Coronary Plaque Regression

For decades, coronary plaque was framed as a progressive accumulation, with treatment aimed at slowing rather than reversing the process. That framing has shifted with[…]