Requirement of higher copayments for prescription drugs can delay the start of treatment for patients with newly diagnosed chronic problems, such as hypertension, hypercholesterolemia, and diabetes. This finding is particularly salient in patients who have no prior experience with prescription drugs.

The Medicare Prescription Drug Benefit (Part D) was initiated to help protect beneficiaries from increasing drug costs and to reduce the cost-related underuse of medications. A recent study by Zhang and associates1 provides noteworthy information about how Part D has affected prescription drug and other medical expenditures.

The rapid spread of Klebsiella pneumoniae carbapenemases (KPCs) is limiting the effectiveness of carbapenems in the treatment of multidrug-resistant infections. The resistance genes found in KPCs have been identified in other organisms as well and have properties that have raised concerns regarding their transmissibility and epidemic potential.

Asthma is a prevalent disease that continues to be associated with significant health care costs. Kamble and Bharmal, for example, estimated that the annual direct medical expenditure attributable to asthma in the United States was about $37.2 billion in 2007. In their study, the estimated prevalence of asthma was 8.7% in children and 6.72% in adults.

In this new feature, you’ll findpaired photographs of two differentdermatological disorders, accompaniedby a checklist of clinical features.You are invited to go throughthe checklists and match the variouscharacteristics with one or both ofthe disorders illustrated.

Roughly 85% of all acute ankle injuriesare sprains, of which about85% are uncomplicated, involving thelateral ligaments only.

THAT BLUE LIGHT KILLS methicillin-resistant Staphylococcus aureus (MRSA) was demonstrated in the article “Visible 405 nm SLD Light Photo-Destroys Methicillin-Resistant Staphylococcus aureus (MRSA) In Vitro,” in the December 2008 issue of Lasers in Surgery and Medicine. Concerns about the clinical safety of the wavelength used (405 nm, spectral width 390 to 420 nm), which contains traces of ultraviolet light, led Chukuka Enwemeka, PhD, and colleagues from the School of Health Professions, Behavioral and Life Sciences at New York Institute of Technology in Old Westbury, to recapitulate the experiment using a wavelength of 470 nm with similar results.

THE VALUE OF THE PEDIATRIC heptavalent pneumococcal conjugate vaccine (PCV7) in preventing pneumococcal meningitis has been confirmed by a study, the results of which were recently published in the New England Journal of Medicine.

Match the following characteristics with the clinical disorders pictured in the photographs of Cases 1 and 2. Then read the brief descriptions that follow on the next page to see how well you did.

Progressively worsening nasal congestion and headaches with diplopia and left proptosis for 2 months prompted an ophthalmology consultation for a 67-year-old woman. She had been evaluated multiple times for allergic rhinitis and recurrent sinusitis.

You come by to see your patient after she has been discharged from the ICU. She is staring at a tray of food in front of her, which is undisturbed. She has lost 15 lb during the past week of hospitalization in the ICU. You ask her why she isn’t eating and whether she is hungry. She says that she is famished but is so weak she can’t even feed herself.1

A 35-year-old woman presented to the emergency department (ED) with 2 black eyes, facial swelling, and other injuries (Figure 1). She said that she had been in an all-terrain vehicle accident the day before, in which she hit her face on the handlebar. She said she had lost consciousness for an unknown period and since the accident had experienced headache, dizziness, nausea, and pain over much of her body.

Sulfonamides are among the most commonly reported causes of drug-induced thrombocytopenia. 1 Affected patients typically present with purpura and platelet counts of less than 20,000/μL after about 7 days of therapy.1-3

A woman in her 70s who underwent mastectomy of the left breast forcancer some time ago.

I consider the FDA’s recent advisory committee recommendations to restrict acetaminophen products inappropriate.

These circular, erythematous lesions of varying sizes on a 45-year-old woman’s dorsal right hand and extensor surface of the right forearm are

Asthma is a prevalent disease that continues to be associated with significant health care costs. Kamble and Bharmal,1 for example, estimated that the annual direct medical expenditure attributable to the treatment of asthma in the United States was about $37.2 billion in 2007, which represents a significant proportion of health care resource use.

Many of my patients who use eyedrops have had great success with the following technique.

Patients are usually unaware of lesions that may have developed on their back.

To increase the cooperation of preschool children during an otic examination, try playing the “magic flashlight” game