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Slightly altering Dr Michael W. Kahn's article for hospital-based physicians, "Etiquette-Based Medicine," for the outpatient setting helps me develop rapport with patients.

Can You Hear Me Now?

Here's a tip for dealing with patients who are hard of hearing and either don't have hearing aids or don't have them in at the time, usually while they are inpatients in the hospital. Take your stethoscope and let them wear the earpieces.

Incision and drainage of an abscess is painful, but it is also painful to pack and repack until the site has healed. I have found that after the initial packing is removed, instilling lidocaine without epinephrine using a syringe without the needle lessens the discomfort and anxiety of repacking considerably.

Systemic inflammation has been identified as a risk factor for the development of heart failure in population studies. In the 5-year prospective MESA study, researchers from Johns Hopkins Hospital in Baltimore recorded a baseline nonspecific marker of systemic inflammation, C-reactive protein (CRP).

Researchers from Massachusetts General Hospital in Boston presented results from the PROTECT (ProBNP Outpatient Tailored Chronic Heart Failure) study. NT-proBNP (b-type natriuretic peptide) is a biomarker released from myocardial tissue in response to high levels of wall stretch and has been studied as a marker for decompensated systolic heart failure.

Are persons with asthma at risk for other proinflammatory disorders? Yes, say researchers from the Mayo Clinic and Olmsted Medical Center in Rochester, Minn, who found that asthma is associated with the development of diabetes mellitus and coronary artery disease. However, there was no association between asthma and rheumatoid arthritis or inflammatory bowel disease.

In the next few minutes, nationally recognized expert, Dr Robert Schoen, will discuss the latest findings on Lyme disease.

You could argue that medicine was never meant to become a for-profit business the way selling cars, cosmetics, and fast food are businesses. And yet, in the United States, health care has become a for-profit business. The story of how this happened is complex, but decisive elements include the advent of Medicaid and Medicare in 1966 and the widespread availability of employer-sponsored health insurance.

Splenic Infarction

A 53-year-old woman presented with sudden onset of left upper quadrant abdominal pain. She had a history of atrial fibrillation, hypertension, and congestive heart failure.

Apple Core Lesion

A 48-year-old woman was hospitalized for acute-onset abdominal pain. She had a history of adult-onset Still disease and severe osteoarthritis. She had been taking 650 mg of aspirin every 4 hours to relieve her arthritis pain and fevers.

Based in Atlanta, Elizabeth Woodcock is a speaker and author with more than 20 years of experience in the practice management industry. Author of ten best-selling books, she holds an MBA from The Wharton School. Learn more at www.elizabethwoodcock.com. You can also reach her directly at elizabeth@elizabethwoodcock.com.

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Bacterial meningitis and herpes simplex virus type 1 (HSV-1) encephalitis are both associated with significant morbidity and mortality. Thus, hospitalization and prompt initiation of therapy are essential.