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I recommend a simple exercise tohelp would-be joggers avert laterproblems.

I recently diagnosed type 2 diabetes mellitus in a 33-year-old man who has no diabeticsymptoms, proteinuria, or evidence of nephropathy. His blood pressure is low(100/60 mm Hg).

Patients on a low-fat diet who dislikethe color, taste, or consistency of fatfreemilk can try adding nonfat milkpowder.

My patient has a test-proven Candida allergy. Because hepatitis B virus (HBV)vaccine contains yeast, another physician would not give it to him. I administereda diluted dose and then a full-strength dose of the HBV vaccine, and the patienthad no adverse reaction.

My patient is a 78-year-old man who complains of severe exhaustion, lack of energy,and hot flashes.

What is bovine spongiform encephalopathy(BSE), or “mad cow disease,” and how is itthought to infect cattle?

All too often, when lancing a sebaceouscyst or abscess, or when relievingpressure from a traumatizednail bed, both practitioner and assistantare splattered with the materialthat is released.

Many of my patients with chronic pain are women who are depressed and whohave experienced a tragedy of some sort in their past.

To facilitate the swallowing movementsthat are key to the examinationof neck swellings-particularlythose of the thyroid gland-give thepatient a full cup of water and askhim or her to drink it slowly whileyou examine the neck.

Pandemics attributable to different influenza A virus subtypes occurredat irregular intervals throughout the 20th century. Because the timingof a pandemic cannot be predicted, we must be prepared for such an outbreak.Although influenza is generally viewed as an illness with potentiallydeadly effects primarily for elderly persons, it can lead to significant morbidityand mortality in otherwise healthy infants and toddlers and in other highriskgroups.

An electric heating pad can burn patientsif they fall asleep while usingit.

A 68-year-old man with severe emphysema complains ofchest pain that began that morning. He has also had intermittentdiarrhea and occasional blood in his stool for thepast 2 weeks.

When you examine patients withGraves disease, be careful when youpalpate the enlarged thyroid gland.

A 2-month-old infant is brought to the office by his parents becausehe has been crying inconsolably for the past 4 to 5 hours. The childhas been well since birth and has no history of vomiting, diarrhea, fever, orrash. The infant is being breast-fed, is not taking any medication, and hasnot been in contact with any sick persons.

Right hip pain in a high schoolfootball playerA 15-year-old boy complains ofright hip pain that began the day before,when he felt a "pop" during footballpractice. His medical history issignificant only for several ligamentousinjuries in both ankles and fracturesof the right lateral malleolusand the left medial malleolus, whichhealed uneventfully. He denies anabolicsteroid use and alcohol use.

Place domestic violence pamphlets inthe women’s restroom.

In his article, "Dyslipidemia: Closing the Treatment Gap"(CONSULTANT, April 1, 2003, page 451), Dr David Nashrecommends statin therapy for all eligible elderly patients.

Here is a painless way to locate andremove splinters. First, inject the areawith a local anesthetic. Then, startingat the point of entry, use a scalpelto make an incision along the track ofthe splinter while you simultaneouslyapply pressure at the opposite, deepend.