Shortly after awakening, an 82-year-old man with a history of cataracts in both eyes noticed a sudden painless diminution of vision in the left eye. He had no new headaches or jaw claudication. His medications included hydrochlorothiazide and atorvastatin.
An 89-year-old woman, who has long lived on the special care (dementia) unit of a nursing home because of advanced Alzheimer disease, is seen to assess possible injuries after a fall. Many prior falls have been ascribed to her lack of safety awareness in negotiating the environment, rather than to neuromuscular, sensory, or cerebellar deficits.
Diagnosing the cause of abdominal pain in a child can be difficult. When I suspect appendicitis, I ask the patient to jump down from the exam table. If this causes no pain, the diagnosis is most likely not appendicitis. Pain indicates rebound tenderness, and further workup is likely needed.
The weight of some of my patients exceeds the upper limit of our office scales. Rather than invest in a more expensive scale for this small group of patients, we placed 2 scales side by side.
When patients come in for a Pap smear, we have them write their name and address on an envelope, which we file in a box organized by month. Then as results come in, we retrieve the appropriate envelopes from the box and mail them out. Any envelopes left in the folder at the end of the month serve as reminders that those patients haven't been contacted yet.
When I dry-shave patients in preparation for surgery or suturing, I find that a mailing label best removes the shaved hair.
Before you prescribe an anticholinergic for patients with urinary frequency or urge incontinence, advise them to cut out all caffeine. Complete avoidance--rather than just decreased intake--often results in an immediate improvement in symptoms.
When you examine a young child's ears, position the patient on the parent's lap with his or her abdomen against that of the parent, one leg on either side of the parent's trunk, and the child's head against the parent's chest.
Use a saturated sterile cotton ball whenever you need to irrigate ears or other small, hard-to-reach places.
Acute parotiditis is characterized by unilateral swelling of the parotid gland with associated erythema and tenderness. Purulent secretions from the Stensen duct may be noted in more than 50% of the cases.
These photographs were taken after a 45-year-old woman accidentally dropped a hot curling iron onto her right eye while she was styling her bangs. The images show white coagulation of the superficial corneal epithelium, erythema of the lateral infraorbital area, and a transverse pale area of the superior eyelid. Severe pain occurred immediately after the injury. The vision in her right eye was partially obscured by the white coagulation.
The decision about when to initiate therapy for Parkinson disease (PD) is highly individual and requires discussion with the patient. Delaying treatment because of a patient's fear of side effects may not be in his or her best interests.
BOSTON -- Exercise in the six weeks before a hip or knee replacement led to significant improvements in preoperative muscle strength and a 73% lower-risk of needing care at a rehab facility after arthroplasty.
TORONTO -- Patients with disabling osteoarthritis who consider a knee or hip replacement to be a realistic option are more likely to become a recipient of one than those who are of two minds, Canadian researchers said.
BOSTON -- Women who exercised four or more hours a week for years were 40% less likely to have a live birth after in vitro fertilization (IVF), according to a study of more than 2,200 patients.
SAN FRANCISCO -- Even with appropriate antibiotics, methicillin-resistant Staphylococcus aureus (MRSA) infections relapse about 25% of the time, researchers reported here. And for MRSA-related osteomyelitis, there is a 46% relapse rate.
SAN FRANCISCO -- A porcine wrinkle has emerged in the struggle against community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) in The Netherlands, researchers recounted here.
WASHINGTON -- The Heart Rhythm Society said today that the FDA should tighten up post-market surveillance of pacemakers and implantable cardioverter defibrillators (ICD). It would also ditch the word "recall" as not sufficiently specific.
ROCKVILLE, Md. -- The FDA has approved Vectibix (panitumumab), a monoclonal antibody that targets the epidermal growth factor receptor (EGFR), for treatment of metastatic colorectal cancer.
COLUMBUS, Ohio -- Twelve of every 1,000 high school football players who played last year were injured during a game. So were 5.21 of every 1,000 girls during game-day soccer.
