Posts in Internal Medicine

A half-emptied blister pack of tablets resting on a printed DNA sequencing trace, dramatic side light on the foil, illustrating antidepressant pharmacogenomics.

The Dose That Never Landed: Antidepressant Pharmacogenomics and the Enzymes That Decide

Key Takeaways: July is Minority Mental Health Month, and antidepressant pharmacogenomics deserves a place in that conversation for a strictly biochemical reason. Two liver enzymes,[…]

A rusted iron chain coiled in a shallow pool of rainwater on grey flagstones, illustrating the unchecked iron accumulation of hereditary hemochromatosis.

The Door That Will Not Close: Hepcidin, the HFE Gene, and Hereditary Hemochromatosis

Key Takeaways: Iron has exactly one way out of the cells that absorb it. That exit is ferroportin, the sole known cellular iron exporter, and[…]

An older person's hands resting open and unclenched on a linen tablecloth beside a ceramic cup in soft morning light, accompanying an article on vagus nerve stimulation for rheumatoid arthritis.

The Reflex That Turns Down Inflammation: A Pivotal Trial of Vagus Nerve Stimulation in Rheumatoid Arthritis

Key Takeaways: Vagus nerve stimulation for rheumatoid arthritis sounds implausible until you follow the anatomy. The nervous system does not merely register inflammation; it regulates[…]

An amber prescription vial with a blank white label on a sunlit wooden windowsill, plain white tablets scattered beside it in a hard shaft of light, illustrating how photosensitizing medications turn ordinary sun into a burn.

The Sunburn in Your Medicine Cabinet: How Photosensitizing Medications Amplify Ordinary Sunlight

Key Takeaways: July is UV Safety Month, and a meaningful share of the burn risk is sitting in the medicine cabinet rather than in the[…]

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[…]