A 21-year-old man presents with a "swelling" in the testicle that he first noticed about 1 month earlier while showering. He does not recall any previous scrotal tenderness; because he has been frequently palpating the lesion, he cannot say for certain whether it is currently tender.

An 81-year-old woman with a history of moderate Alzheimer dementia, depression, coronary artery disease, hypertension, and type 2 diabetes mellitus was accompanied to the office by her son for a routine follow-up appointment.

A 66-year-old woman was hospitalized because of severe anemia secondary to myelodysplastic syndrome. She had had associated fatigue and throbbing pain in both legs for several days.

The Dutch Guillain-Barré Study Group found that intravenous immunoglobulin and therapeutic plasma exchange were equally effective in the treatment of GBS. The Plasma Exchange/Sandoglobulin Guillain-Barré; Syndrome Trial Group demonstrated that therapeutic plasma exchange alone, intravenous immunoglobulin alone, and therapeutic plasma exchange immediately followed by a course of intravenous immunoglobulin were all equally effective.

The development of more sophisticated testing modalities now permits the identification of coronary artery narrowing in asymptomatic adults. The images obtained in these studies provide potential targets for intervention-based therapy.

Worsening painful ulcers on both legs prompted a 62-year-old woman to seek medical attention. She had a history of rheumatoid arthritis (RA), demonstrated by the markedly deformed interphalangeal joints in her thumbs (A), and scleroderma-polymyositis overlap syndrome.

A 74-year-old woman presented with a refractory pruritic eruption. Four months earlier, she had sought evaluation of a thickened, slightly crusted 6 3 8-cm patch on her right ankle of 2 months' duration. Contact dermatitis with secondary impetigo from scratching was suspected, and a topical corticosteroid and an oral antibiotic were prescribed.

I often drive home key points I make to patients by drawing on the paper cover on the examining table. A graph, a key lab value, an anatomical aid--indeed, any kind of visual aid--is likely to help patients "get" the concept I am trying to explain.

The sharply demarcated, smooth red plaques on this 3-year-old's tongue had been present for several months.

Over the past 20 years, the treatment armamentarium for diabetes has greatly expanded: 8 different classes of non-insulin drugs and 8 different types of insulin are now available. The newer classes of agents include disaccharidase inhibitors, thiazolidinediones, meglitinides, glucagonlike peptide analogs, and dipeptidyl peptidase IV inhibitors.

CHICAGO -- Physicians will be able to report smoking-cessation counseling efforts soon using two new Current Procedural Terminology (CPT) codes that address tobacco use specifically.

SYDNEY, Australia -- Stretching before or after exercise won't spare either elite athletes or weekend warriors from muscle soreness one to three days later, investigators here have found.

PHILADELPHIA -- Ulcerative colitis patients had up to a 50% reduction in colectomy risk at one year when treated with infliximab (Remicade), found pooled results of trials at two doses.

SYDNEY, Australia -- Traditional Chinese remedies may ease painful menstrual cramps better than nonsteroidal anti-inflammatories (NSAIDs) and other drugs, according to a Cochrane systematic review.

NASHVILLE -- Mortality for new hemodialysis patients can be reduced by 41% during the first year of treatment by an intensive case monitoring program, researchers here found.

NEWCASTLE, Australia --Three antifibrinolytic agents each reduced blood loss and red-cell transfusions associated with elective surgery, without an increased risk of thrombosis, according to a literature review.

LIVERPOOL, England -- Amniotomy during a spontaneous birth did not reduce the time of labor or improve the condition of the newborn, according to a systematic review of the literature.

PHILADELPHIA -- The benefits of screening colonoscopy extend to patients 80 and older, according to two studies reported here.

STANFORD, Calif. -- In mid-level coronary artery disease, outcomes are about the same for either angioplasty or bypass graft surgery, found researchers here.

PHILADELPHIA -- Most patients with gastroesophageal reflux disease continue to have reflux, despite twice-daily dosing with a proton pump inhibitor, according to results of a study reported here.