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Break a disposable wooden cotton swab to create an instrument to test for sharp sensation.

What key question can you ask patients with chronic pain that may help lead you to a diagnosis?

A 60-year-old man presented with a pruritic rash on the chest and abdomen that had developed over a week in the summer, after a spate of yard work. The patient had multiple excoriated erythematous papules, some of which were hyperkeratotic. Joe R. Monroe, PA-C, MPAS, of Oklahoma City reports that biopsy of one of the lesions revealed epidermal hyperkeratosis and acantholysis, which confirmed the clinical diagnosis of Grover disease, or transient acantholytic dermatosis.

For 2 days, a 60-year-old man with a history of gout had excruciating pain in the left big toe. During 2 previous episodes, colchicine had relieved his symptoms. On this occasion, colchicine failed to provide relief. The patient's first metatarsophalangeal joint of the left foot was erythematous, hot, and tender. He could not bear weight on the foot. Other physical examination findings were normal.

For 20 months, a 23-year-old woman had bone pain that traveled to all of her extremities and was unrelated to physical activity. Physical findings were normal. An isolated increase in the serum calcium level was noted. Radiographs of the left and right femurs revealed diffuse diaphyseal thickening. A nuclear medicine bone scan demonstrated increased activity in the diaphyseal regions of the long bones, with a slight increase in cranial uptake.

A review of the environmental determinants of allergic rhinitis and asthma, including house dust mites, cats, dogs, and cockroaches.

Avoidance of allergens and irritants known to cause or aggravate allergic rhinitis and asthma is a key component in the management of these disorders.

BETHESDA, Md. - Inherited variations in a gene that codes for skin pigmentation can dramatically increase the risk of acquiring mutations in another gene that's linked to one form of melanoma, according to researchers here.

ST. LOUIS PARK, Minn. - Constipation can trigger physical aggression in a nursing home resident with dementia, researchers here reported.

SEATTLE - Blind drunk is much more than a vivid description of big-time intoxication, according to investigators here. It is also a state of visual inattention while driving that may not take much alcohol to attain.

ROCKVILLE, Md. - The FDA today granted accelerated approval to Sprycel (dasatinib) for adults with chronic myeloid leukemia who are intolerant to Gleevec (imatinib) or become resistant to it.

EDINBURGH - A new set of clinical criteria-embodied in a Web-based tool-improves the ability of oncologists to diagnose patients with Lynch syndrome, according to Scottish researchers.

BALTIMORE ? Don't let the bedbug's bite go misdiagnosed, pediatric dermatologists here advise. A simple set of diagnostic principles may help to determine whether a child's rash comes from bedbug or flea bites, or something else.

DENVER - Treatment decisions for localized prostate cancer tend to be driven more by patients' fears and misconceptions rather than by understanding of the evidence, according to accounts of newly diagnosed patients.

NEW YORK - Blood that has been awaiting use in a hospital for several weeks has been associated with a higher risk of complications in patients undergoing repeat cardiac surgery.

NEW HAVEN, Conn. - Preserved placentas from children later diagnosed with autism contained cellular abnormalities that could be the earliest signs of the condition.

PARIS ? Diagnostic chest x-rays apparently bestow an increased risk of breast-cancer in women with mutations in BRCA susceptibility genes.

ROME - Cell phone signals alter the excitability of the nearby motor cortex, according to researchers here, who don't know what the finding means, if anything.