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I read with interest Dr Gregory Rutecki’s Top Papers Of The Month feature, “Treat Dementia in Elderly Patients With Caution” (CONSULTANT, January 2009, page 60). Elderly patients who live at home and those in long-term–care facilities often pose management challenges, whether they have evident Alzheimer disease or other diagnoses. While I am not in favor of bad medicine, consideration should be given to treating agitated, violent, and apparently angry and hostile persons with what works. I do not favor quieting noisy patients with drugs.

It results from reactivation of latent varicella-zoster virus (VZV) within the

This lesion had appeared in the right groin of a 60-year old man and had slowly enlarged over a month (A). Two years before this evaluation, he had undergone total prostatectomy with lymph node dissection for prostate carcinoma. Metastatic disease was found in a resected lymph node, and he underwent multiagent chemotherapy.

The patient is a 54-year-old man, a native of Poland who has lived in the United States for many years. A diagnosis of AIDS was made in 1994, when Hodgkin disease (nodular sclerosing Hodgkin lymphoma) was found in an enlarged cervical lymph node and he tested positive for HIV during his workup.

The 1990s were an exciting decade for the treatment of chronic kidney disease (CKD). The addition of angiotensin-converting enzyme inhibitors (ACEIs) and then angiotensin receptor blockers to the antihypertensive armamentarium helped preserve renal function and decrease proteinuria in patients with CKD.

In a recent AIDS Reader editorial, Joel E. Gallant called for clinicians who treat persons with HIV/AIDS to “become vocal advocates for routine HIV screening,

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Alzheimer disease (AD) is more than twice as likely to develop in elderly persons with orthostatic hypotension (OH) as in those without OH, according to a new study presented at the Annual Meeting of the American Academy of Neurology.

An 88-year-old man who had left hip repair after a fracture a few months earlier is now admitted to behavioral hospital because of implacable refusal to take medications, and because of poor food intake and ongoing refusal of rehabilitation. Ambulated with a walker before fracture but now barely ventures out of wheelchair even with rolling walker and therapist guidance.

It seems that every mother operates from a standardplaybook.

An all-terrain vehicle-ATV-is described by the American National Standards Institute as one that "travels on low pressure tires, with a seat that is straddled by the operator, and with handlebars to be used for steering."1 By this definition, an ATV is designed for interactive riding by a single operator. Drivers are able to shift their weight freely in all directions depending on the situation and terrain. According to ATV safety standards and recommendations, children younger than 6 years are never to be on an ATV of any size-alone or with someone else.

Prolonged exposure to high-risk strains of human papillomavirus (HPV) and the dysplastic effects that HPV exerts on cells of the squamocolumnar transitional junction of the anal canal lead to anal intraepithelial neoplasia (AIN), which is a precursor to squamous cell carcinoma of the anus (SCCA).1 Anal HPV infection is present in 93% of HIV-positive men who have anoreceptive intercourse.2 Furthermore, anal dysplasia of any grade has been reported in 56% of HIV-infected men who participate in anoreceptive intercourse.3,4

Anal cancer has become one of the most common non–AIDS-defining tumors in HIV-infected persons.1,2 The incidence of anal intraepithelial neoplasia (AIN) is also markedly increased in HIV-positive men,3 particularly those who have sex with men (MSM), despite the introduction of highly active antiretroviral therapy.4

Elderly persons with essential tremor (ET) are almost twice as likely to have dementia as those without ET, according to a new study from Elan Louis, MD, professor of neurology, and colleagues at Columbia University in New York.

Sleep disorders are common in persons older than 70 years, according to a large community-based study of age-related diseases and cognitive functioning. The most common disorder, sleep-related leg cramps, occurred in 32% of the study participants, according to investigator Jennifer Molano, MD, a behavioral neurology fellow at the Mayo Clinic in Rochester, Minnesota.

Physicians are failing to diagnose HIV infection among older patients,

Researchers have identified 2 gene variations that are resistant to interferon ß therapy. This finding could lead to a biomarker for determining when IFN-ß is appropriate for the treatment of multiple sclerosis.

Prevalence of migraine is higher in men and women who have total body obesity (TBO) or abdominal obesity (Abd-O), according to the results of a study by Lee B. Peterlin, DO, assistant professor in the Department of Neurology, and colleagues at Drexel University College of Medicine in Philadelphia.