May 3rd 2024
Your daily dose of the clinical news you may have missed.
Medical Crossfire®: Maximizing Patient Outcomes in Shingles – Are You Leveraging Guideline Based Care?
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Understanding RSV: What You Need to Know to Prevent and Treat Respiratory Syncytial Virus in Your Patients
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Respiratory Syncytial Virus: Understanding the Infection Burden and Anticipating the Impact of Vaccines
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Medical Crossfire®: Which Patients with Hematologic Malignancies are at Risk for Secondary Immunodeficiency (SID)… and How Can We Leverage Evidence to Improve Their Outcomes?
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Patient, Provider, and Caregiver Connection™: Prevention and Control of Meningococcal Disease — Individualizing Vaccine Recommendations in Adolescent Populations
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How to Handle Chronic Cough in Kids:
December 1st 2003ABSTRACT: A cough is considered chronic when it persists for 3 or more weeks. Typically, chronic cough is a lingering manifestation of a viral upper respiratory tract infection; other, more serious causes-such as asthma, sinusitis, or gastro- esophageal reflux-must also be considered. Look to the history for diagnostic clues and order a chest film, which may point to pneumonia, hyperinflation, atelectasis, or cardiac or pulmonary abnormality. Diagnostic test methods will depend, in part, on the child's age; for example, the American Academy of Pediatrics recommends against imaging of the sinuses in children 6 years or younger. Pulmonary function tests can be useful in diagnosing asthma if the child is able to cooperate. Consider ordering a barium swallow for a very young child whose cough may be the result of a vascular anomaly. A pH probe study can help you determine whether cough is secondary to gastroesophageal reflux. Treatment is directed at the underlying cause.
Kaposi Sarcoma on the Foot Mimicking an Eccrine Poroma
November 1st 2003For 3 months, a 50-year-old man had been bothered by a worsening and spreading rash on his feet and lower legs. The multiple, nodular, fungating lesions were nonpruritic. The heterosexual, unmarried patient did not use intravenous drugs and did not know his HIV status; he denied any significant medical history.
Elephantiasis Verrucosa Nostrum
September 1st 2003A 62-year-old obese woman with adult-onset type 1 diabetes mellitus had a 6-year history of bilateral leg edema. During the last year, the edema worsened and the skin on her legs thickened. She also had multiple, bilateral, painful, superficial ulcers that drained copiously.
Obese Young Girl With Acanthosis Nigricans and Vaginal Yeast Infection
September 1st 2003A 12-year-old African American girl comes to youroffice for a well-child checkup. She is tall for herage (height above the 95th percentile) and obese(body mass index [BMI] above the 95th percentile).Physical examination reveals acanthosisnigricans on her neck, axilla, and upper abdominalregion (Figure) and a vaginal yeast infection.Routine urinalysis reveals a glucose level ofgreater than 1000 mg/dL, with negative proteinand ketones. A random blood glucose test, obtainedbecause of the glucosuria, is 249 mg/dL.
Man With Chronic Eustachian Tube Dysfunction, Otitis Media, and Hearing Loss
September 1st 2003A 31-year-old man presents with a2-week history of a constant, dull acheand hearing loss in the right ear. Healso complains of intermittent sharppains that are usually followed bydrainage through the external auditorycanal. Another practitioner diagnosedacute otitis media with tympanic membraneperforation, for which he prescribeda 10-day course of amoxicillin.The patient completed the regimen buthas obtained no relief.
Smallpox Vaccination: The Risks for Patients With Atopic Dermatitis
September 1st 2003Because of recent threats of bioterrorism, smallpox vaccination was reinstated in the United States earlier this year. Since January 2003, more than 35,000 civilian and public health care workers in 54 jurisdictions have been vaccinated.
Dyshidrosis and Photoallergic Drug Reaction
August 2nd 2003A slightly pruritic, red, scaly rash on an 8-year-old boy’shands has been progressively worsening since it appeared4 months earlier. Nail pitting also was noted. There are noother rashes on his body. The patient is active in sports;denies any new exposure to soaps, clothing, or other contactants;and spends time in the homes of his recently divorcedparents.
Preventive Medicine and the "Road to Hell"1
August 1st 2003Many of my patients are confused. So aremany of my colleagues. Official bodies ofexperts barrage the media with pronouncementson what constitutes goodpreventive medicine: screening tests, eatingor abjuring certain foods, avoidance of exposures tosun or environmental hazards, "correct" behaviors. Althoughthey acknowledge that the data are, and alwayswill be, imperfect, these experts try their best to directpeople in the way that the evidence points-for now.
West Nile Virus Infection: Are You Prepared?
August 1st 2003n the United States, the number of cases and geographic range of West Nile virus infection have increased since 1999, when the virus first surfaced in the Western Hemisphere. This year, the virus is expected to spread to all states except Alaska and Hawaii.