Authors
Latest:
“Complementary” Therapies in Multiple SclerosisWhat happens when complementary and alternative therapies are combined with traditional treatments in patients with multiple sclerosis? A new study suggests some positive benefits. Details here.
Latest:
Complementary Therapies in Multiple Sclerosis: Why Mind-Set Is EverythingHere: a project that sheds some light on the potential of an integrated and holistic approach to therapy for patients with multiple sclerosis.
Latest:
Pasteurella Pneumonia Associated With Cutaneous TraumaCommunity-acquired pneumonia is a frequent cause ofhospital admission in adults. It usually results from infectionwith pathogens such as Streptococcus pneumoniae, Haemophilusinfluenzae, Mycoplasma, and Chlamydia, among others. In a fewcases, pneumonia develops from infection with unusualpathogens, such as Pasteurella multocida, a gram-negativeorganism commonly found in the mouths of cats and dogs.We report a case of P multocida pneumonia associated with skintrauma caused by cat scratches in a woman with a history ofchronic obstructive pulmonary disease. [Infect Med. 2008;25:487-489]
Latest:
Tension and Cervicogenic Headaches:ABSTRACT: A thorough history and physical examination can establish the diagnosis of tension headache; further evaluation is generally unnecessary. In contrast, the workup of cervicogenic headache includes standard radiographs, 3-dimensional CT, MRI, and possibly electromyography; nerve blocks may also be used to confirm the diagnosis. Episodic tension headache can be treated effectively by trigger avoidance, behavioral modalities, and structured use of analgesics. Reserve opioids for patients with intractable headaches. Chronic tension headache is treated primarily by prophylactic measures, such as antidepressants and anticonvulsants, and behavioral and physical therapy. Treatment options for cervicogenic headache include analgesics; invasive procedures, such as trigger point injections, greater or lesser occipital nerve blocks, facet joint blocks, segmental nerve root blocks, and diskography; spinal manipulation; and behavioral approaches.
Latest:
Green Nail SyndromeGreen discoloration of the fingernailsdeveloped 6 weeks after a 29-year-oldwoman had artificial nails placed duringa manicure. The patient was a doctorof pharmacy degree candidate whowas married and had 2 children.
Latest:
Woman With Transient Year-Round White, Numb, Cold HandsA woman has white, numb, cold hands after vigorous exercise, emotional stress, and exposure to cold. Is this caused by Buerger disease (thromboangiitis obliterans), acute arterial occlusion, Raynaud disease, or acrocyanosis?
Latest:
Managing Drug Interactions That Can Reduce Levothyroxine EfficacyLevothyroxine is one of the most commonly prescribed medications for the treatment of persons with hypothyroidism and the suppression of thyroid neoplasms.1 Most persons with hypothyroidism require lifelong therapy with levothyroxine.
Latest:
Linear Gingival ErythemaBleeding gums for the past 2 days was the complaint of this 22-year-old woman. She is HIV-positive but has been clinically asymptomatic. Her CD4 lymphocyte count is 84/μL, and her viral load is 160,885 copies/mL. Despite maintaining good oral hygiene, she has a distinct fiery red band along the gingival margin.
Latest:
The Solitary Lung Nodule:ABSTRACT: When a solitary lung nodule is detected, the key question is whether the lesion is malignant. The initial evaluation includes a careful history taking focused on risk factors for malignancy, a thorough physical examination, comparison of current chest films with previous ones, and CT scanning. Radiologic signs that suggest malignancy include lesion size greater than 2 cm in diameter, spiculated margins, lack of calcification, and change in size. Video-assisted thoracoscopic surgery or thoracotomy is the next step for patients with a suspected malignant lesion. If the results of the initial evaluation are equivocal, positron emission tomography (PET) scanning is the preferred follow-up.
Latest:
Oncology Q&AIs prophylactic oophorectomy recommended for healthy postmenopausal women with a strong family history of cancer?
Latest:
6 Top Primary Care Items From Around the WebA look around the web at breaking news -- not all of it medical.
Latest:
Acute Protrusion of the ScapulaSeveral hours after he had installed ceramic tile, a 33-year-old man experienced muscle spasms and felt pressure in his right shoulder. He denied previous injury to the area.
Latest:
Blue Rubber Bleb Nevus SyndromeBRBNS is a rare GI disorder characterized by distinctive cutaneous and GI venous malformations that can lead to occult or massive GI bleeding.
Latest:
Malignant Melanoma in a Patient withMulti-organ Metastatic DiseaseThis truncal lesion was revealed when a 47-year-old man disrobed for examination after he had fallen on a sheet of ice and broken a rib. The patient-a truck driver and 30 pack-year cigarette smoker-had been aware of the enlarging lesion for about a year but had not sought medical attention because it was asymptomatic.
Latest:
Woman Who Has Felt Unwell for Many YearsA 41-year-old woman presents as a new patient, with complaintsof chest pain and palpitations that occur intermittentlyand are not associated with activity, meals, or position.She says these symptoms have been present forsome time, and she expresses frustration that her previousphysician was unable to find their cause or to amelioratethem.
Latest:
Clostridium difficile-Associated Diarrhea:For some time, diarrhea caused by Clostridium difficile has been a serious problem in hospitals. Recently, more virulent strains of this pathogen have started to show up in hospitals.
Latest:
Bronchoscopy Clinic: Emerging options for managing foreign-body aspirationEndobronchial foreign bodies can be life-threatening, but once they are detected, they can usually be removed, leading to prompt resolution of symptoms. Chest radiography and CT scanning can be helpful in some cases, but bronchoscopy is necessary for definitive diagnosis and treatment.
Latest:
ISCHEMIA: Initial Revascularization Did Not Reduce Adverse CV Outcomes in SIHDAHA Scientific Sessions 2019: In SIHD patients with moderate-severe ischemia, initial revascularization + OMT compared to OMT alone did not reduce the risk for adverse CV outcomes
Latest:
What Are These Lesions?These circular, erythematous lesions of varying sizes on a 45-year-old woman’s dorsal right hand and extensor surface of the right forearm are
Latest:
Takotsubo Cardiomyopathy in a Man With a Gunshot WoundA 48-year-old African American man with no significant medical history sustained a gunshot wound to the face and shoulder.
Latest:
Disseminated Intravascular Coagulation as an Unusual Presentation of Acute Retroviral SyndromeMultiple atypical presentations of acute retroviral syndromehave been reported in the literature, but rarely has acute retroviralsyndrome been associated with disseminated intravascularcoagulation (DIC). We detail a case of a 19-year-old manadmitted to the hospital with initially unexplained severe DICthat on workup was found to be secondary to acute retroviralsyndrome. [Infect Med. 2008;25:24-28]
Latest:
Rhabdomyolysis Secondary to Urinary Tract Infection With E coliRhabdomyolysis is linked to infection in up to 31% of cases. However, only 19 cases of rhabdomyolysis related to E coli infection have been reported.
Latest:
HIV-Positive Woman With DyspneaA 48-year-old African Americanwoman with HIV infection who hadbeen hospitalized several days earlierfor presumed Pneumocystis cariniipneumonia (PCP) is readmittedbecause of worsening dyspnea and atemperature of 38.8oC (102oF).She also complains of painful swellingand erythema on her right arm.Her symptoms have worseneddespite treatment with trimethoprimsulfamethoxazole.
Latest:
Chronic Kidney Disease in Primary Care: Essential Basics ReviewPrimary care plays an essential role in identifying CKD, monitoring and slowing disease progression, and providing timely referral, when indicated, to nephrology.
Latest:
Histoplasmosis mimicking metastatic carcinomaThe differential diagnosis forendobronchial lesions includesbut is not limited toneoplastic causes, benign tumors,infections, and foreignobjects. We report a case of anunusual cause of endobronchiallesions.
Latest:
A covert cause of hypoxemia: Intravascular pulmonary lymphomaWe describe a patient with intravascularpulmonary lymphomawho presented withprogressive dyspnea and hypoxemiawith normal chest radiographicfindings. After anunrevealing noninvasive evaluation,a high-grade B-cellintravascular lymphoma wasdiagnosed by bronchoscopywith transbronchial biopsy.Treatment with a modifiedCHOP regimen resulted in resolutionof the patient’s hypoxemiaand exercise limitation.Although intravascular pulmonarylymphoma rarely presentswith pulmonary symptoms,it should be consideredin the differential diagnosis ofpatients presenting with hypoxemiaand normal chest radiographicfindings.
Latest:
Man With Headache, Diplopia, Nausea, and VomitingA 68-year-old man presents to the emergency department with diplopia and headache of acute onset accompanied by nausea and vomiting.
Latest:
Papilledema in NeurosarcoidosisSix days ago, a 36-year-old man had noticed a dark spot in the field of vision of his left eye. Now the spot more closely resembled a line. He denied other changes in his vision and had not seen any floaters or flashing lights.
Latest:
Submacular HemorrhageOne morning, an 83-year-old woman woke up to find a gray-colored spot in the central vision of her right eye. The spot was constant, and she could not see through it. She had a history of dry age-related macular degeneration and cataract surgery in both eyes.
Latest:
Atypical Manifestation of BrucellosisA 49-year-old farmer was hospitalized because of a 3-week history of intermittent fever, fatigue, anorexia, generalized myalgias, and malodorous sweating. A nonpruritic, nonhemorrhagic, maculopapular rash recently had developed on his arms, legs, and trunk. The reddish lesions were less than 1 cm in diameter. There was no history of antibiotic or antipyretic drug therapy, and no abnormalities were found on physical examination.
