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SAN DIEGO -- When the Marine Corps evaluated thousands of recruits, it found that young men, ages 18 to 20, were significantly more likely to become risky drinkers if they started drinking as children or young teenagers.

EDMONTON, Alberta -- When enthusiastic hockey fans get into it, the sound in an indoor arena can rise to the level of a jet aircraft taking off, with the risk of permanent hearing damage.

ZURICH, Switzerland -- Rare-earth magnets -- now being packaged into necklaces and bracelets -- may have a deadly attraction for patients with pacemakers and implanted defibrillators, warn researchers here.

CLEVELAND -- The abrupt halt to clinical trials of torcetrapib, an investigational HDL-boosting agent, raises questions about any drug that inhibit cholesteryl ester transfer protein (CETP), according to cardiologist Steven Nissen, M.D., of the Cleveland Clinic.

Porokeratosis is a clonal disorder of keratinization that features patches with raised red rims and atrophic centers. The histologic hallmark of porokeratosis is the cornoid lamella, the pathologic substrate of the ridgelike border.

Blue nevi are a manifestation of dermal melanocytosis.1 They consist of blue, gray-blue, or brown-blue papules that occur most commonly on the head and neck. The blue pigmentation is attributable to the depth of melanin in the dermis and the Tyndall effect (the preferential absorption of long light wavelengths by melanin and the scattering of shorter wavelengths, representing the blue end of the spectrum, by collagen bundles).

Actinic (solar) keratoses are found on sun-exposed skin of elderly white persons-in particular redheaded or blond patients, who tend to burn frequently and tan poorly. Actinic keratoses are the most common sun-related growths in white persons.

A variety of benign lesions in elderly patients involve proliferation of melanocytes. These lesions include dysplastic nevi, which histologically contain somewhat asymmetric nests of melanocytes; compound nevi, which histologically contain more symmetric nests of melanocytes in the dermis and epidermis and intradermal nevi, which histologically contain nests of melanocytes in the dermis.

Stucco keratosis is considered a variant of seborrheic keratosis. The name probably derives from the resemblance of the lesions to old stucco on the sides of houses. Stucco keratosis is thought to result from thickening of the epidermis, in particular the stratum corneum, which histologically resembles a church spire.

NEW YORK -- The older antipsychotic drug, Trilafon (perphenazine), is significantly cheaper and no less effective than four newer medications for the treatment of chronic schizophrenia, according to researchers here.

I enjoyed Dr Henry Schneiderman’s “What’s Your Diagnosis?” case of an elderly woman with severe facial ecchymoses from a fall. Would Dr Schneiderman elaborate on several points about that case? This woman did not trip or complain of dizziness before she fell. What caused her to fall?

ANN ARBOR, Mich. -- A tumor board's thorough reassessment of recommendations for breast cancer surgery led to changes in treatment planning for more than half of the patients in a year, according to researchers here.

NEW YORK -- For many schizophrenia patients, switching antipsychotic drugs may improve symptom control with fewer side effects. But other patients, already doing well, may be better off standing pat, showed a randomized trial.

Because of the potential complications associated with mechanical ventilation, noninvasive ventilation is considered an attractive alternative in some settings. How useful is it in patients with acute cardiogenic pulmonary edema? Researchers who addressed this question found that the early application of noninvasive ventilation in the emergency department (ED) can decrease the relative risk of mortality by 39% and the need for endotracheal intubation by 57%.

A major disadvantage of unfractionated heparin is its intravenous administration and the need for coagulation monitoring and hospitalization. However, subcutaneous administration may be an alternative, according to Kearon and coworkers. They found that fixed-dose subcutaneous unfractionated heparin appears to be as effective and safe as low molecular weight heparin (LMWH) for the outpatient treatment of acute venous thromboembolism (VTE).

ABSTRACT: Age-related changes that affect drug distribution, such as increased total body fat, decreased muscle mass, and decreased total body water, necessitate reduction in the dosage of water- and lipid-soluble agents. Because creatinine clearance declines with age, the dosage of agents that are excreted primarily by the kidney must also be lowered to prevent toxicity. Examples include aminoglycosides, fluoroquinolones, penicillins, procainamide, lithium, angiotensin-converting enzyme inhibitors, and digoxin. A good rule of thumb to follow until creatinine clearance can be calculated is to reduce the total dose by half in frail elderly persons or in those with established renal disease. Anticholinergic agents should be used with caution because they are associated with urinary retention, heart block, constipation, dry mouth, blurred vision, sedation, and acute or chronic confusion in elderly patients.

ABSTRACT: Painful recurrent ulceration of gingival tissue suggests a secondary intraoral presentation of herpes simplex virus (HSV) infection. Unlike the lesions of HSV, lesions associated with coxsackievirus do not erupt in the anterior mouth but rather on the soft palate and pharynx. Furthermore, unlike HSV infection, coxsackie infections may recur, because there is considerable viral variation. Patients with atrophic or erythematous candidiasis report burning pain and a metallic taste. The typical patient with benign mucous membrane pemphigoid is a woman older than 50 years; the condition usually involves the attached gingiva around the teeth. The lesions of erythema multiforme may erupt on any intraoral mucosa; biopsy may be required to rule out other conditions with similar presentations.

Is it appropriate to routinely order urinalysis for patients in a nursing home (both with and without dementia) when they exhibit behavioral changes but show no signs or symptoms of urinary tract infection (UTI)?