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Internal Medicine

Cutaneous lesions

Damola A. Adegbenro, MD, and Noah S. Scheinfeld, MD, JD September 02, 2010

Two patients present with similar cutaneous growths—one a series of ulcerative lesions on the lower leg, and the other a painless forearm lesion.

Exposure to moisture leads to palmar rash

Caroline Y. Winslow and Julia R. Nunley, MD September 02, 2010

A 24-year-old woman presented with a six-year history of a recurring, somewhat painful and pruritic palmar rash that developed on either hand within minutes of exposure to water.

Collis-Nissen fundoplication for a symptomatic paraesophageal hernia

Ashley L. Racette, PA-C, MPAS; Richard T. Miller, MD September 02, 2010

A laparoscopic approach leads to relief of the patient's gastroesophageal reflux, uneventful surgery, and a smooth recovery

Tender, edematous, red plaques on a woman's hands and feet

Jennifer Stead, DO, and Stuart Gildenberg, MD August 25, 2010

One month after starting a new chemotherapeutic drug, the patient sought treatment for painful peeling and redness on her hands and feet.

PPIs: Good for ulcers, bad for the bones

August 19, 2010

Taking PPIs for several years can significantly raise the risk of osteoporosis-related fracture.

Compression fractures in a man with osteoporosis

August 19, 2010

An 83-year-old male with an osteoporotic compression fracture of the second lumbar vertebra (L2), sustained in a fall, complained of continuing pain despite conservative treatment for the past 3 weeks.

Osteoporosis in men: How to treat this condition in the atypical patient

August 19, 2010

Prevention and treatment guidelines for osteoporosis frequently overlook that the disease can affect men. In fact, men fare much worse than women after a fracture.

Making the best use of osteoporosis agents

Jack Waxman, MD August 19, 2010

There are changes in the wind for patients with osteoporosis and their clinicians. But don't underestimate currently available therapies.

Screening for osteoporosis

August 19, 2010

Osteoporosis is associated with significant morbidity and mortality, especially if it results in a hip fracture. Within the year following hip fracture, 12% to 20% of patients die, more than 30% have permanent disabilities, and more than 50% can never live independently again. Ten million Americans have osteoporosis, and an additional 18 million with osteopenia are at risk.

HPV cotest affects cervical cancer screening

August 10, 2010

Clinicians are likely to test the patient more frequently when using Pap and human papillomavirus (HPV) tests together, a survey shows.

Modifiable risk factors cause most strokes

August 10, 2010

Targeted interventions could substantially reduce the burden of stroke.

Hyperkeratotic plaques span from head to toe

Joshua Weingartner, Pamela S. Allen, MD, FAAD, and Heather Hennigan, PA-C August 10, 2010

Five months of treatment with corticosteroids and antibiotics did not relieve the scaly plaques on a man's scalp, cheeks, trunk, genitals, and legs.

Imaging options for patients with acute abdominal pain

Brady Pregerson, MD August 10, 2010

Each of the three primary modalities—plain films, diagnostic ultrasound, and CT scan—must be weighed against their strengths and weaknesses.

Bacterial meningitis complicated by seizures and confusion

August 10, 2010

Myoclonic seizures began following surgery to repair a cerebrospinal fluid leak in a 73-year-old woman.

Patches of hair loss

Sean D. Doherty, MD August 04, 2010

Two boys present with similar hair loss—one developed only months earlier, the other had been present since birth.

Sun-sensitive drugs may lead to cataracts

August 04, 2010

The active ingredients in a broad range of medications may make a person more vulnerable to age-related cataracts.

Pruritic hand lesions in a 25-year-old restaurant worker

Peter M.H. Cham, MD, and Erin M. Warshaw, MD, MS August 04, 2010

An otherwise healthy restaurant worker presented with pruritus, erythema, and wheals over the distal forearms and the dorsal...

HbA1c not reliable for diagnosing diabetes

August 03, 2010

A new analysis found that this measure is inferior to the oral glucose tolerance test for screening.

Triple regimen for lowering BP

July 26, 2010

An investigational triple regimen of olmesartan medoxomil (OM), amlodipine besylate (AML), and hydrochlorothiazide (HCTZ) may result in significantly greater mean reductions in...

Helicobacter pylori infection: Update on diagnosis and management

July 15, 2010

The sequelae of H. pylori infection are causative factors in gastric cancer. Eradication of the bacteria, however, is difficult because of it's...

Recurrent erosions on the neck and axillae

William Sargent Kaufman and Julia R. Nunley, MD July 15, 2010

A woman presented with erythematous plaques that waxed and waned throughout the year, but were more symptomatic in the summer.

CVD prevention: tighter aspirin recs for diabetics

July 15, 2010

In a joint statement, published online, the American College of Cardiology Foundation, American Diabetes Association, and American Heart Association updated their recommendations for primary-prevention aspirin use in people with diabetes.

Mild cognitive impairment: The transition to Alzheimer's disease

Andrea Pace, MSBS, PA-C; Karen Graham, MPAS, PA-C July 13, 2010

Cholinesterase inhibitors are the most promising agents for slowing progression to Alzheimer's disease. But for how long can this progression be delayed?

Diabetes, high LDL speed Alzheimer's decline

July 13, 2010

A history of diabetes or high cholesterol (especially LDL) can speed cognitive decline in patients with Alzheimer's disease.

Glucose control may improve upper GI symptoms

July 07, 2010

Diabetics prone to upper gastrointestinal difficulties may find relief with better glycemic control.

Nuts, fibrates help heart; pneumonia shots don't

July 07, 2010

The results of several unrelated studies point to the cardioprotective effects of nut consumption and fibrate use, but not the pneumonia vaccine.

Misdiagnosis and mismanagement of food allergies?

July 07, 2010

A literature review from the Stanford University School of Medicine's Center for Primary Care and Outcomes Research has uncovered several sources of confusion that could...

Alzheimer's management from diagnosis to late stage

By Freddi Segal-Gidan, PA, PhD July 07, 2010

Post-diagnostic care can be challenging. Beyond assessment and treatment, clinicians need to deal with educational support and legal issues.

The latest on HIV screening, diagnosis, and management in primary care

July 07, 2010

Faced with an increasing number of HIV cases in this country—predominantly attributed to transmission by newly-infected persons—the CDC has issued revised screening recommendations that will impact primary care.