September 3rd 2024
The updated COVID-19 vaccine targets the currently circulating Omicron variant JN.1 strain of SARS-CoV-2.
Chest Film Clinic: What caused persistent cough and dyspnea in this patient?
October 1st 2006A 65-year-old woman presented to her primary care physician with a 3-month history of worsening cough, now productive of copious blood-tinged secretions. She also reported a recent onset of fever and dyspnea. She denied any chest pain, chills, night sweats, and weight loss.
Exploring the link between nasal allergy and sinus infection
October 1st 2006Abstract: There is solid evidence that a positive association exists between nasal allergy and acute or chronic sinusitis in both adults and children. Patients with perennial allergic rhinitis--especially those with significant sensitivity to molds and/or house dust mites--are particularly susceptible to acute sinusitis. It therefore seems reasonable to assume that controlling rhinitis by controlling allergens in the home environment will minimize recurrences of acute sinusitis. Conversely, many patients with chronic sinusitis also have nasal allergy. Thus, management of nasal allergy should be included in the treatment strategy for chronic sinusitis. (J Respir Dis. 2006; 27(10):435-440)
Parkinson Disease: REFERENCES: EVIDENCE-BASED MEDICINE: RELEVANT GUIDELINES:
October 1st 2006ABSTRACT: Signs that strongly suggest Parkinson disease (PD) include unilateral hand tremor, slowed or decreased movement, and gait changes. Postural alterations include leaning forward or asymmetric shoulder height; the arm may not swing when the patient walks, or it may be held flexed at the elbow. Patients may report increasing difficulties in occupational and social functioning. Mimics of PD include essential tremor, normal pressure hydrocephalus, other neurodegenerative diseases, and drug-induced parkinsonism. Most patients report such nonmotor symptoms as sleep disturbances, visual difficulties, bowel and bladder problems, fatigue, depression, and anxiety. Cognitive impairment in many patients takes the form of slowing of memory and difficulty with visual spatial tasks and executive function. A more realistic treatment goal than tremor eradication is improved overall mobility.
Contaminated Ocular Products: When the Solution Is the Problem
October 1st 2006In recent months, the widely publicized outbreak of Fusarium keratitis has called attention to the serious consequences of contamination of ocular solutions. Although contact lens solution was implicated in the recent outbreak, other ocular products can also pose the risk of infection (Box).
Nasal Allergy and Sinus Infection:
October 1st 2006ABSTRACT: There is solid evidence that a positive association exists between nasal allergy and acute or chronic sinusitis in both adults and children. Patients with perennial allergic rhinitis--especially those with significant sensitivity to molds and/or house dust mites--are particularly susceptible to acute sinusitis. It therefore seems reasonable to assume that controlling rhinitis by controlling the home environment will minimize recurrences of acute sinusitis. Conversely, many patients with chronic sinusitis also have nasal allergy. Thus, management of nasal allergy should be included in the treatment strategy for chronic sinusitis.
Role of Corticosteroids in Treatment of Infection
October 1st 2006I have recently seen several patients who were treated for infections by emergency department physicians and who were given oral corticosteroids along with antibiotics. My understanding of the action of corticosteroids is that they suppress the immune system. If this is true, why would they be given to someone who already has an infection?
Rhinitis and Sinusitis: Related, or Not?
October 1st 2006If left untreated, sinusitis can cause significant physical symptoms and can negatively affect quality of life by substantially impairing the daily functioning of sufferers. For children, this can mean learning difficulties at school and for adults, a loss of efficiency at work.
Treatment of Infection: Role of Corticosteroids
October 1st 2006I have recently seen several patients who were treated for infections by emergency department physicians and who were given oral corticosteroids along with antibiotics. My understanding of the action of corticosteroids is that they suppress the immune system. If this is true, why would they be given to someone who already has an infection?---
Shoulder Fracture-Dislocation in an Elderly Woman: Would You Operate?
October 1st 2006An 89-year-old woman, who has long lived on the special care (dementia) unit of a nursing home because of advanced Alzheimer disease, is seen to assess possible injuries after a fall. Many prior falls have been ascribed to her lack of safety awareness in negotiating the environment, rather than to neuromuscular, sensory, or cerebellar deficits.
ICAAC: Amalgam Dental Fillings Fend Off Bacteria Better than Composite
September 29th 2006SAN FRANCISCO -- The debate about mercury in amalgam dental fillings not withstanding, amalgam is superior to composite material in reducing adherence of caries-causing Streptococcus mutans, researcher said here.
A Call to Test for H. Pylori Before Starting NSAIDs in High Risk Patients
September 22nd 2006BIRMINGHAM, Ala. -- The American Gastroenterology Association has issued recommendations aimed at balancing the gastrointestinal and cardiovascular pluses and minuses when using nonsteroidal anti-inflammatory drugs (NSAIDs).
Women With Breast Implants Have Elevated Suicide Rate
September 21st 2006OTTAWA, Ontario -- A large study of women with cosmetic breast implants found they had a suicide rate over two decades that was 73% higher than the general population -- but the rate was similar to that of women who had other cosmetic procedures.