Excess weight increases the risk of having a heart attack, stroke, high blood pressure, arthritis, diabetes, depression, fatigue, and certain types of cancer. Losing weight and keeping it off are very difficult for most persons who are overweight. Here are some suggestions to help you lose pounds and keep your weight down.
In this article, we review the factors that contribute to obesity. We then describe effective approaches to weight control, including exercise, dietary modification, drug treatment, and bariatric surgery.
Phenytoin is one of the most commonly prescribed antiepileptic drugs in both acute and chronic settings; its use has been extensively described. Nevertheless, interactions between phenytoin and numerous other drugs continue to complicate seizure therapy; these have been documented in case reports, studies, textbooks, and epilepsy reviews.
A 39-year-old woman who had a fever and episodes of nonbloody vomiting for 5 days presented to the emergency department after the sudden onset of severe, left-sided flank pain (10/10 severity) that was sharp, constant, and radiated to the front. She had no associated urinary symptoms, vaginal discharge, or bowel disturbances. Her last menses, 10 days earlier, was regular. Aside from a urinary tract infection 2 years earlier, her medical history was insignificant.
A 56-year-old man presents with diffuse erythema. He has not changed his routine or eaten anything unusual. The rash initially appeared the previous night as asymptomatic erythema on the face and body. On awakening in the morning, the patient noticed that the erythema had spread over most of his body and had become pruritic. Over-the-counter diphenhydramine did not relieve the symptoms.
To easily drain an ulnar bursa or a patellar effusion of any size--and simplify preparation of the aspirate for transfer--use an evacuated blood draw kit with an 18-gauge needle attachment, a see-through-labeled tube coated with whatever anticoagulant your laboratory specifies, and several large additive-free tubes. Begin with the coated tube
When examining a patient who complains of earache, start by looking in the "good" ear.
Dermclinic: A Photo Quiz to Hone Dermatologic Skills
An 85-year-old man was hospitalized because of lower GI bleeding. He was hemodynamically stable. Because gastroscopy and colonoscopy failed to reveal the source of the bleeding, push enteroscopy was performed. This study showed an ulcerated tumor in the proximal jejunum.
Monday morning your nurse hands you charts for 4 new patients. Each patient is a woman with widespread body pain, stiffness, and fatigue. All have already been evaluated by another physician and were advised that they should reduce stress and practice distraction techniques. They are in your office today seeking a second opinion.
A 45-year-old man comes to see you for a routine physical.He has no complaints and no significant medical history.However, while questioning him you discover that he usedintravenous heroin until about 10 years ago-and sometimesshared needles. He also drank 6 or more beers a day for about 20 years, a practicehe stopped at the same time that he quit using illicit drugs. He has multiple tattoos,which were done at commercial parlors. He is married but has no children. His wife hasno history of hepatitis. Physical examination is unremarkable.
A nonhealing ulcer recently developedin a painful facial rash that hadworsened over several months. The44-year-old patient is a heavy drinkerwith a history of elevated liver functionlevels. She has had numerousunprotected sexual contacts over theyears.
The parents of this 5-month-old boy were concerned that his eyes wereturned in toward the nose. The infant was otherwise healthy. Physical findingswere normal. In particular, when a light source was projected onto theeyes, the light reflex was centered in both eyes.
The "Quick Take" on water fluoridation states that "fluorideprevents caries primarily after tooth eruption" (CONSULTANT,March 2001, page 472).
How can you readily determinewhether your patient with bronchitismay benefit from an inhaled bronchodilator?
Advise patients to use moist heat totreat spinal or extremity injuries duringthe first 48 hours.
Several techniques can decrease thediscomfort of an endometrial aspiration.
Although widely regarded as a raredisorder, hereditary hemochromatosisis the most common genetic disease inCaucasians. In certain populations ofnorthern European descent, 1 of every200 persons is homozygous for thecausative mutation.1
As many as 300,000 sportsrelatedconcussions arediagnosed each year inthe United States.1 Thisfigure underestimatesthe true incidence, however, becausemany concussive injuries are notrecognized by the injured persons,trainers, or physicians. A recentstudy found that 4 of 5 professionalfootball players with concussionwere unaware that they had sufferedthis injury.2
Endobronchial foreign bodies can be life-threatening, but once they are detected, they can usually be removed, leading to prompt resolution of symptoms. Chest radiography and CT scanning can be helpful in some cases, but bronchoscopy is necessary for definitive diagnosis and treatment.
