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Almost 2 years ago I reviewed the topic of hepatitis C virus (HCV) infection in the setting of HIV.1 Given the advances–and some setbacks–in our understanding of HCV pathogenesis and treatment in the coinfected population, it's time for an update.

A 46-year-old man is seen by medical personnel with new skin injuries of the upper limbs as shown. States he has not had such injuries before. Denies altercations with knife wielders; also denies self-mutilation or any sexual practice involving bondage or injury.

For 2 weeks, a 43-year-old white female had worsening nausea and multiple episodes of vomiting. Her symptoms began with increased malaise and decreased appetite. The emesis was unrelated to meals and was sometimes accompanied by mild abdominal distention. She had occasional fevers but denied any recent contact with ill persons. She also reported a 12-lb weight loss, decreased energy level, and an increased tan complexion over the past several months.

Primary care practice is filled with patients who have acute coronary disease complicated by multiple comorbid conditions. In this era of percutaneous treatments, contrast-induced nephropathy persists as an unwelcome and debilitating complication.

The left lateral decubitus position is both a less awkward and a more productive position for digital rectal examinations than the standard one in which the patient bends over the examining table.

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.

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.