September 20th 2024
FluMist is the first influenza vaccine that does not have to be given by a health care professional.
Cold Weather Dermatoses: How to Recognize and Treat
December 31st 2006Prolonged exposure to coldtemperatures can have a profoundeffect on the skin.When tissues are exposed toabove-freezing temperatures,localized vasoconstriction and increasedblood viscosity reduce bloodflow and decrease the amount ofoxygen available to tissues. Whentissues are exposed to freezing temperatures,water within those tissueschanges into ice crystals; this resultsin either intracellular or extracellulardamage and tissue necrosis.
Update on Rifampin and Rifabutin Drug Interactions
December 31st 2006Rifampin is associated with numerousclinically significantdrug interactions.1-4 New interactionswith rifampin-aswell as rifabutin-continue tobe reported in studies and clinical observations.Here we present highlightsof our recent update on the interactionsthat are most relevant toprimary care practice.5
Acute Dx: What Cause of Sudden Illness?
December 31st 2006A 60-year-old woman reportsthat she has felt intermittent“fullness” in her face for the past day.This sensation is present when sheis supine on the examination table.She denies shortness of breath, dysphagia,and chest discomfort. Thepatient has a 25 pack-year history ofcigarette smoking.
Erythematous Rash in Man Receiving Vancomycin Infusion
December 31st 2006A 67-year-old man with poorly controlled type 2 diabetes mellitus presents withleg pain and swelling that began 3 days earlier. Multiple ulcers are noted at thelateral malleolus. His temperature is 38.9°C (102.1°F). Right lower extremitycellulitis is diagnosed, blood samples are taken for culture, and the patient ishospitalized.
A Photo Quiz to Hone Dermatologic Skills
December 31st 2006A 28-year-old woman complains that her acne has worsened since she startedtaking minocycline for the skin condition 6 weeks earlier. She also uses a norgestimate/ethinyl estradiol oral contraceptive, which has an indication for acnetreatment. Numerous small, pruritic, erythematous follicular papules are presenton the patient’s forehead, cheeks, and nose
A Photo Quiz to Hone Dermatologic Skills
December 31st 2006A 29-year-old woman presents with a painful erosive dermatitis that has spreadin a perioral distribution during the last 2 days. She complains of a low-gradefever and swollen lymph nodes. The patient has a history of atopy; she isotherwise healthy and takes no medications.
A Photo Quiz to Hone Dermatologic Skills
December 31st 2006During the past few weeks, a 14-year-old boy has noticed blood on the proximalnail folds of the second and third fingers of his dominant hand. He deniesany pain or pruritus. The patient is otherwise healthy and takes no prescriptionmedications.
Acute, Severe Dyspnea in an Older Man With COPD
December 31st 2006An 82-year-old man suddenly became extremely short of breath while helpinghis wife wash dishes. The dyspnea was not accompanied by pain, and it was notrelieved by sitting. He was taken to the emergency department after diaphoresisand cyanosis developed.
Diagnostic Images, Treatment Issues
December 31st 2006A39-year-old man is brought to theemergency department (ED)after his car struck a tree. He experienceda transient loss of consciousnesswith a 3-minute episode of retrogradeamnesia at the scene of the accident,despite wearing a seat belt andshoulder harness. He was disorientedto date and place.
A Photo Quiz to Hone Dermatologic Skills
December 31st 2006For 2 days, a 43-year-old woman has had a slightly tender rash on her trunk andextremities. Five days earlier, the patient was given levofloxacin for an upperrespiratory tract infection; because she is prone to yeast infections while takingantibiotics, fluconazole also was prescribed. Her only other medication is an oralcontraceptive, which she has been taking for several years.
Acute Dx: What Cause of Sudden Illness?
December 31st 2006For 2 weeks, a 35-year-old woman has had a mass on her hand.Although it was initially painless, it now causes discomfort in the forearm,especially when the patient extends her wrist. She has no history of recenttrauma, illness, or a similar mass.
Acute Dx: What Cause of Sudden Illness?
December 31st 2006The parents of a 6-year-old child are concerned about blisterson her hands that erupted 3 days earlier and are spreading. The child isotherwise healthy and had attended a summer day camp. The parents areunaware of any trauma or exposure to allergens or toxic substances.
Elderly Woman With Severe, Worsening Dyspnea
December 31st 2006An 88-year-old woman is admitted for severe dyspnea thathas worsened over the past month. Dyspnea on exertionis now elicited by everyday activities, even walking acrossthe room. Orthopnea and paroxysmal nocturnal dyspneahave progressed to the point that she has been unable tosleep at all the past several nights. She also tires very easilyand thinks her ankles are more swollen than previously.She denies chest pain or pressure.
A Photo Quiz to Hone Dermatologic Skills
December 31st 2006For 3 months, a 57-year-old woman has had a persistent green nail that is occasionallyslightly sore; the nail plate has lifted. Another physician prescribed a7-day course of levofloxacin for a suspected Pseudomonas infection; the treatmenthad no effect on the nail. A subsequent 7-day course of norfloxacin wasalso unsuccessful. The patient is otherwise healthy.
Do You Recognize These Nail Disorders?
December 31st 2006During a routine skin examination,periungual erythema and increasedcurvature of the nail plate are notedin a 78-year-old man. The patient hasemphysema and a smoking historyof more than 50 pack-years. Currently,he requires oxygen support forregular daily activity.
Young Man With Unilateral Eye Discomfort and Redness
December 31st 2006A 25-year-old man complains of moderate discomfort, burning, redness, serousdischarge, and slightly impaired vision in his right eye; he also has mild photophobia.His symptoms began suddenly about 36 hours earlier, and the discomforthas increased steadily since that time. The left eye is unaffected.
Young Man With Cough and Dyspnea
December 31st 2006A 22-year-old man presents to theemergency department with a2-week history of a worsening nonproductive,irritating dry cough andexertional dyspnea. The patient hasbeen otherwise healthy. He deniesfever, rigors, night sweats, hemoptysis,chest pain, palpitations, orthopnea,paroxysmal nocturnal dyspnea,ankle edema, and lymphadenopathy.
A Photo Quiz to Hone Dermatologic Skills
December 31st 2006A 26-year-old man who presentswith acne mentions that he has had“Raynaud’s” for 10 years. His eyelidsare pinkish violet and swollen. Nailfold telangiectases are present,and violaceous papules and scaleoverlie the joints. The patient deniesany other symptoms.
KRUGMAN’S INFECTIOUS DISEASES OF CHILDREN (ed 11)
December 31st 2006Infections continue to be the leading killer of children worldwide.This text-now in its 11th edition-provides comprehensiveyet concise information on the natural history, diagnosis,treatment, and prevention of the major infections thataffect children. New to this edition are chapters on fungal infections,eye infections, cholera, dengue and dengue hemorrhagicfever, helminthic infections, and malaria. All otherchapters have been extensively revised and updated to coversuch topics as smallpox vaccination, bioterrorism, newer hepatitisviruses, and Pseudomonas infections in patients withcystic fibrosis. Included in the appendices are the indications,contraindications, adverse effects, and drug interactions ofantimicrobials used in children; the recommended childhoodand adolescent immunization schedule; and a discussion ofsevere acute respiratory syndrome. More than 50 color photographs-as well as numerous radiographs, photomicrographs,diagrams, charts, and tables-accompany the text.