Hear an interview with Ted Rosen, MD, professor of dermatology at Baylor College of Medicine, and chief of Dermatology Service at Veterans Affairs Medical Center, Houston. Dr Rosen has a keen interest in current healthcare reform; he recently attended a summit in Washington with a group of think-tank leaders who are at the forefront of reform efforts.
On January 15, 2010, top congressional Democrats reported that they were “close” to an agreement with the White House on cost and coverage issues and that a draft would soon be sent to the Congressional Budget Office, the official authority on the cost and extent of coverage that any new legislation would provide. However, the outcome of the Massachusetts Senate race has created a significant obstacle to passing a health care reform bill for the Democrats in the Senate.
A 38-year-old man had fever and fatigue for the past 6 days and tenderness in the left upper abdominal quadrant for the past 3 days. He also had a facial butterfly rash that had been present for 10 years and a 1-year history of lupus nephritis, treated with prednisone and mycophenolate. He denied respiratory complaints or recent weight loss.
A 26-year-old woman at 30 weeks’ gestation presented to the emergency department with a throbbing frontal headache of 1 month’s duration. She had also had peripheral blurred vision for the past 2 weeks. Acetaminophen initially decreased her pain but was no longer effective. She had had a previous miscarriage.
Both of the disorders presented in Cases 1 and 2 typically have the face as the primary site of involvement, and both are benign processes
Malignant thymoma is an indolent tumor arising from the thymic epithelial cells located in the anterior mediastinum. These tumor cells spread via regional metastasis or invade surrounding structures, including the pleural space.
To obtain a general idea of intestinaltransit time when doing a workupfor chronic constipation or shortbowelsyndrome, I use this simpletest:
Patients with kidney stones areoften sent home with a bulky plasticfilter cup and told to use it to straintheir urine.
Recurrent or persistent vaginal itching is a common problem. If antifungals have not been effective, ask the patient, while she is in the stirrups, to point to the pruritic spot or touch it with her finger.
For versatile, portable heat therapy,have patients run a hand towelunder hot tap water, ring it outslightly, then put it in a large ziplockbag.
Editor’s note: In a recent issue (CONSULTANT, November 2009, page 676), Dr Gregory Rutecki made the case for diagnosing dehydration on the basis of physical findings rather than relying solely on elevated blood urea nitrogen (BUN) and creatinine levels.
