Authors


Bijoy E. John, MD

Latest:

Pseudotumor

A 45-year-old man with a history of congestive heart failure presented with cough and dyspnea. A chest roentgenogram showed loculated pleural effusion in the horizontal fissure of the right lung, and a CT scan revealed pleural-based density in that lung.


Bijoy Telivala, MD, MBBS

Latest:

Emphysematous Pyelonephritis Caused by Pasteurella multocida

Emphysematous pyelonephritis (EPN) is a rare but life-threatening infection characterized by widespread necrosis and production of gas within the kidney.


Biljinder Chima, MD

Latest:

STEMI With Underlying Paced Rhythm

According to the Sgarbossa criteria, the patient had an acute MI: ECG revealed a greater than 1-mm ST-segment depression in lead V2 and about 5-mm discordant ST-segment elevation in leads II, III, and aVF.


Bill Zaforau, MD

Latest:

Aging Matters: Delirium in Hospitalized Elderly Patients: How You Can Help

An 83-year-old man presents to the emergency department after he fell down his basement stairs and was unable to walk.


Bishoy Faltas, MD

Latest:

With HIV, Location Matters

It turns out that where a patient gets a diagnosis of HIV affects how quickly he or she gets treatment for the infection.


Bizath Taqui, MD

Latest:

Wolff-Parkinson-White Syndrome: What Treatment?

A 29-year-old man presents with a recent episode of light-headedness of sudden onset. Although he denies associated loss of consciousness, witnesses report that he was briefly unresponsive to verbal stimuli. He also denies chest pain, dyspnea, palpitations, and diaphoresis; he is currently asymptomatic.



Bob L. Lobo, PharmD

Latest:

Statin-Drug Interactions: Update on the Most Common and Clinically Significant

Statins (HMG-CoA reductase inhibitors) are the most effective drugs in the management of elevated low-density lipoprotein cholesterol (LDL-C) levels. Recent large clinical trials continue to demonstrate the remarkable efficacy of these agents, including improved outcomes.


Bobbak Vahid, MD

Latest:

Pulmonary involvement in a patient with lymphocytic colitis

Microscopic colitis is a noninfectiouscolitis that is characterizedby chronic nonbloodydiarrhea and macroscopicallynormal colonic mucosa. Extraintestinalmanifestationsare rarely seen. In this report,we describe a nonspecific interstitialpneumonitis in a patientwith lymphocytic colitis.


Bobby Lazzara, MD

Latest:

Restrictive Covenants: What's in Your Contract?

Dr Bobby Lazzara spends a Medical News Minute reminding you to pay close attention to all the fine print.


Bonita T. Mangura, MD

Latest:

Community-acquired pneumonia: An update on therapy

Abstract: In the assessment of community-acquired pneumonia, an effort should be made to identify the causal pathogen, since this may permit more focused treatment. However, diagnostic testing should not delay appropriate empiric therapy. The selection of empiric therapy can be guided by a patient stratification system that is based on the severity of illness and underlying risk factors for specific pathogens. For example, outpatients who do not have underlying cardiopulmonary disease or other risk factors can be given azithromycin, clarithromycin, or doxycycline. Higher-risk outpatients should be given a ß-lactam antibiotic plus azithromycin, clarithromycin, or doxycycline, or monotherapy with a fluoroquinolone. If the patient fails to respond to therapy, it may be necessary to do bronchoscopy; CT of the chest; or serologic testing for Legionella species, Mycoplasma pneumoniae, viruses, or other pathogens. (J Respir Dis. 2006;27(2):54-67)


Boquing Chen, MD, PhD

Latest:

Back Extension Exercises for Patients With Osteoporosis

Exercises that help strengthen themuscles that support the spinemay be especially helpful duringthe postmenopausal years. Theback extension series illustratedin Figures 1 through 5 is anexample of progressively moredifficult exercises that can beperformed several times perweek. These exercises can alsobe performed individually inconjunction with resistance andweight-bearing routines.


Bora Rhim, DPM

Latest:

The Charcot Foot: A Missed Diagnosis Can Cost a Limb

This enigmatic, destructive, and deforming condition most often affects persons who have diabetes.


Bradford A. Kilcline, MD

Latest:

Acute Low Back Pain in Children:

ABSTRACT: Unless the cause of back pain is obvious, order anteroposterior and lateral radiographs of the spine, a complete blood cell count, erythrocyte sedimentation rate, and urinalysis. If you suspect infection, tumor, or bony abnormalities, obtain an MRI or CT scan. MRI has surpassed bone scanning as the gold standard for diagnosing spinal infections, because it confirms a specific anatomic diagnosis. Spondylolysis and spondylolisthesis are 2 of the most common causes of back pain in adolescents; the diagnosis is made with plain radiographs, which show slippage on the later-al view in patients with spondylolisthesis and fracture through the pars interarticularis on the oblique views in those with spondylolysis.


Bradford Bergman, MD

Latest:

Lethargy, Confusion, and Constipation in an Older Woman

A 77-year-old woman is brought for evaluation by her family. The patient had previously been alert and active; however, for the past week, she has been difficult to arouse and, when awake, has been delusional and has behaved abnormally. In addition, for the past 2 weeks, she has complained of abdominal discomfort related to constipation.


Bradford Volk, MD

Latest:

Exercise:

An examination of the evidence on the cardioprotective benefits associated with various intensity levels, types, and amounts of physical activity, as well as tips on a beneficial yet realistic exercise program.


Bradley M. Wright, PharmD, BCPS

Latest:

Hypertension in an African American Man with Diabetes

A 54-year-old African American man with a history of type 2 DM, hypertension, and gout presents for diabetes follow-up. What’s the best therapy for his hypertension?


Bradley Wright, PharmD

Latest:

FDA on Metformin: OK in Some Patients with Reduced Kidney Function

FDA is requiring a class labeling change that will allow many more diabetes patients to benefit from metformin.



Brandon Goodwin, MD

Latest:

Differentiating Common Annular Lesions: Tinea Corporis vs Granuloma Annulare

Tinea corporis typically presents as an annular erythematous plaque with a raised leading edge and scale. Granuloma annulare classically presents with 1 or more indurated, erythematous or violaceous annular plaques on the extremities. Here, more on diagnosis and treatment.


Brandon Hamilton, MD

Latest:

Spontaneous Lung Herniation, Acute Cough, and Pneumonia

The patient described here was treated for pneumonia, but a chest wall mass and CT changes suggested that more was going on.


Brandon Hill, MD

Latest:

Headache as a Rare Presenting Symptom of Löfgren Syndrome

Löfgren syndrome is a form of acute sarcoidosis characterized by a triad of symptoms: hilar adenopathy, erythema nodosum, and arthralgias.


Brandon M. Rhinehart, DO

Latest:

Varicelliform Lesions in a 9-Year-Old Boy

A 9-year-old boy, who has no significantmedical history, presents with a generalizedpruritic eruption of 2 weeks’ duration.One week earlier, another practitionerruled out scabies and treatedhim presumptively for varicella.


Brett D. Leggett, MD

Latest:

Hypertension in a 3-Year-Old Boy

A 3-year-old boy was brought into the office for vague abdominal pain of 5 days’ duration. His mother stated that he had had several episodes of nonspecific pain in the abdomen that lasted a few minutes and resolved spontaneously.


Brett White, MD

Latest:

Tracheal Stenosis: An Uncommon Cause of Dyspnea

A 75-year-old woman presented with worsening dyspnea of about 6 to 8 months' duration. Her symptoms were initially associated with exercise, after about 30 minutes on the treadmill, and now were present at rest. Her breathing pattern had changed to "panting" to improve airflow during minimal activity.


Brian A. Boyle, MD

Latest:

Research Focus: Recent Developments in HIV Therapeutics

Research Focus: Recent Developments in HIV Therapeutics


Brian Boehlecke, MD, MSPH

Latest:

Assessing the risk of crashes in patients with obstructive sleep apnea

ABSTRACT: Patients with obstructive sleep apnea (OSA) are at increasedrisk for motor vehicle crashes as a result of excessivesleepiness. However, a number of factors complicate risk assessment.For example, self-reported sleepiness and the severityof OSA do not appear to be good predictors of accident risk.Many persons with OSA do not accurately perceive their levelof drowsiness-self-reported sleepiness does not correlate wellwith objective measures, such as results of the Multiple SleepLatency Test. Moreover, it is not clear whether objective testscan reliably predict accident risk in the real world, as opposedto during simulated driving. The indications for-and benefitsof-restricting driving in patients with OSA have not been established.However, there is good evidence that the use of continuouspositive airway pressure significantly reduces the riskof crashes in these patients. (J Respir Dis. 2008;29(12):459-464)


Brian C. Halpern, MD

Latest:

Exercise for Patients with Osteoarthritis: A Phased Approach to Plannng

ABSTRACT: Exercise can be an effective way to stabilize or slow the degenerative process of osteoarthritis-provided convenient, safe, and enjoyable activities are selected and achievable goals are set. Implement an osteoarthritis exercise plan in phases, and progress gradually from one phase to the next; this will help both you and your patient anticipate difficulties and gauge progress. The first phase-the initial evaluation-includes gathering baseline data, targeting an area of the body to focus on first, and identifying potential contraindications to activities. Subsequent phases include range of motion exercises (stretching), isometric and isotonic strengthening exercises, and recreational or functional activities. Encourage patients to continue stretching exercises throughout the program.


Brian D. Kuronya, MD

Latest:

Metastatic Squamous Cell Carcinoma

Shortly after arriving from Puerto Rico, a 59-year-old man presented with right-sided frontal head pain and decreased vision in his right eye. He was concerned about a “sore” that first developed 9 months earlier on his head. The patient denied fever, chills, and syncope.


Brian Johnson, MD

Latest:

Bilateral Alien Hand Syndrome

A 68-year-old woman was hospitalized because of confusion and agitation of sudden onset. Her history included dementia and multiple infarcts of both cerebellar hemispheres, bilateral basal ganglia, bilateral parietal lobes, and the right occipital lobe.

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