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A patient of mine recently had an extensive allergy workup after a rash developed, apparently following exposure to wheat products.

What amount-and type-of alcohol is most effective in lowering cardiovascular risk? A recent paper suggests that drinking wine responsibly reduces the risk of heart disease to a greater extent than moderate consumption of beer or spirits, such as whiskey.

The features of acromegaly (frontal bossing, enlarging hands and feet, changes in the prominence of the lower jaw) are so subtle and progress so slowly that patients and family members often miss them.

Primary HIV infection refers to the earliest stages of infection, or the interval from initial infection to seroconversion (when antibody to HIV is detectable). During this stage, many patients have symptoms of acute HIV seroconversion illness, are viremic with very high HIV RNA levels, and have negative or indeterminate findings on HIV antibody tests.

UNICEF has reported that there have been some improvements for children facing AIDS, but progress is still far short of goals set for 2010 (Worsnip P. Reuters. April 3, 2008).

Apart from clinical trials that provide highly active antiretroviral therapy shortly after the recognition of an acute seroconversion reaction-an intervention that some believe could be a prelude to eradicating HIV -there has long been debate over the optimal time to initiate antiretroviral therapy.

Metronidazole, the prototype nitroimidazole, was originally released in 1959 for the treatment of Trichomonas vaginalis infections. It has since been used to treat a variety of infections caused by anaerobic and facultative anaerobic bacteria and protozoa. Here we discuss the need for dosing adjustments in patients with hepatic disease.

Shapiro discussed the numerous studies that reiterate- despite a troubling grassroots opinion among lay Lyme disease advocates and a select group of physicians- that the term "chronic Lyme disease" is a misnomer for other symptom complexes and that long-term antibiotic therapy provides no benefit.1,2 "Patients with these symptoms have been studied at many different scientific centers," explained Shapiro, extrapolating from an article he coauthored that appeared in the October 14, 2007, issue of the New England Journal of Medicine.1 "The majority have no evidence of ever having been infected with the bacteria that causes Lyme disease, either by clinical history or by laboratory tests.

PREVALENCE OF ANAL humanpapillomavirus (HPV) infection was24.8% among a study population of222 heterosexual men who confirmedthat they had never engagedin male-male sexual intercourse. Thestudy is scheduled to appear in TheJournal of Infectious Diseases and canbe viewed ahead of print at the journal'sWeb site.

Postsurgical endophthalmitis caused by Rhizobium radiobacterdeveloped in a 62-year-old man. The patient was treatedwith empiric intraocular therapy. On identifying the causativeorganism, systemic ciprofloxacin was added to the treatmentregimen. Therapy resulted in complete resolution of visualchanges caused by the infection. [Infect Med. 2008;25:274-276]

A66-year-old white man with tuberculosis of the shoulderjoint had a severe hypersensitivity reaction to antituberculosismedications. Symptoms included development of pulmonaryinfiltrates, hepatic dysfunction, renal insufficiency, andneutropenia. The patient improved after the medicationswere withdrawn. [Infect Med. 2008;25:287-291]

A 56-year-old woman with type 2 diabetes mellitus and hypertension presented with acute left-sided weakness and altered mental status, for which she was hospitalized. The patient, who was obese, was in her usual state of well-being until 2 months before this presentation, when she noted a gradual onset of generalized weakness. She received a diagnosis of severe hypokalemia that was refractory to oral potassium supplementation. The outpatient workup of the cause of her hypokalemia was in progress.

As treatments for HIV-1 infection have become more effective, better tolerated, and more conveniently administered, treatment success has increased, but many factors influence treatment response. In addition to issues concerning when to initiate HAART and how to optimize therapeutic potency, challenges related to resistance to antiretroviral therapy in treatment-experienced patients as well as patient demographics and adherence affect antiviral response. [Infect Med. 2008;25:294-298]

A 39-year-old woman presented with dry cough, which she had had for 3 months. She had mild intermittent asthma and a 5 pack-year smoking history. Her symptoms started after an upper respiratory tract infection and persisted despite multiple courses of antibiotics, decongestants, and corticosteroids.

Microscopic colitis is a noninfectiouscolitis that is characterizedby chronic nonbloodydiarrhea and macroscopicallynormal colonic mucosa. Extraintestinalmanifestationsare rarely seen. In this report,we describe a nonspecific interstitialpneumonitis in a patientwith lymphocytic colitis.

Cryptococcus neoformansmost commonly infects personswith an underlying T-cellimmunodeficiency. It hasbeen nicknamed the "sugarcoatedkiller" because it cancause a devastating disseminatedillness in immunosuppressedpatients. C neoformansrarely causes primaryinfection in an immunocompetentpatient. We present acase of pulmonary cryptococcosisthat occurred in an otherwisehealthy man.

Venous thromboembolism (VTE) continues to be a common and potentially life-threatening problem, with an estimated incidence of at least 1 in 1000 persons per year.1,2 VTE includes both deep venous thrombosis (DVT) and the resultant pulmonary embolism (PE). PE occurs in as many as 50% of patients with proximal DVT.3

• The evaluation of cough remains an important clinical problem for primary care physicians and pulmonologists alike. In the past 5 years, the American College of Chest Physicians,1 the British Thoracic Society,2 and the European Respiratory Society3 have published comprehensive guidelines to assist in standardizing the approach to cough evaluation. While determining the cause of cough can be vexing initially, prospective studies have shown that the cause can be established in more than 90% of patients.