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Tai Chi (also known as T'ai Chi Chuan, Taijiquan) is a form of mind-body exercise that has its roots in ancient Chinese martial arts. Throughout Asia, it is often practiced for preventive health, especially among the elderly. In recent years, Tai Chi has become popular in the West among all age groups and has been studied as a therapy for various medical conditions.

Vitamin E has been evaluated for the treatment and prevention of several different chronic diseases in numerous clinical trials over the past 2 decades. However, only a limited number of studies have investigated the potential therapeutic or prophylactic effect of vitamin E on allergic rhinitis and respiratory infections. In contrast to trials on cardiovascular disease, which have failed to demonstrate a benefit from vitamin E supplementation,1,2 there is mounting evidence that this essential vitamin may be useful for prevention of the common cold and treatment of allergic rhinitis.

A 53-year-old man presented with a 3-day history of bilateral pain in the lower extremities. He also had a 3-month history of thickening and desquamation of skin, with associated itching, and a 5-lb (2.27-kg) weight loss. The skin changes initially appeared on the hands and subsequently became generalized.

A 60-year-old woman with a history of iron deficiency anemia was hospitalized because of an episode of melena. A colonoscopy performed a year earlier had shown left-sided diverticulosis but was otherwise unremarkable.

Pruritic, erythematous papules on a man's forearms; nonhealing, asymptomatic ulcers on another man's lip and neck--to what do you attribute these lesions?

A 30-year-old active-duty sergeant with no history of urinary tract disease presented to a combat support hospital with acute pain in the left lower abdominal quadrant. For 4 months, the pain had been mild and intermittent; it had worsened during the past 24 hours. Before deployment, microscopic hematuria had been detected and the soldier had been informed of the possibility of a urinary stone.

Urinary incontinence is common--especially among older adults--but underdiagnosed. Many persons with this disorder are reluctant to discuss it with their physicians; often, only direct questioning can uncover the problem.

57-year-old woman is hospitalized because of a 3-week history of persistent left-sided dull flank pain that worsens with movement and is associated with intermittent high fever.

Although proton pump inhibitors (PPIs) are highly effective, clinical failure in patients with gastroesophageal reflux disease (GERD) is seen regularly--not only in GI clinics but also in primary care offices. In fact, the prevalence of failure with PPIs has increased in proportion to the expanding indications for their use.

We were taught in medical school to wait 3 minutes after a posture change to check orthostatic vital signs. Many patients with orthostatic hypotension experience symptoms immediately on standing.

Some patients are allergic to ester-type anesthetics, such as procaine.

To foster equal stimulation and drainage of both breasts, advise lactating mothers to alternate the breast they begin nursing with at each feeding.

How many bottles of nitroglycerin should your cardiac patients have?

A 51-year-old man with a 20-year history of asthma and seasonal allergies presented with low-grade fever, progressive dyspnea on exertion, and wheezing that had persisted for 2 weeks. Four days earlier, he had been seen by his primary care physician and had started levofloxacin therapy. However, his respiratory symptoms had worsened, warranting hospitalization. He also reported pain in the abdomen and left flank and pain and swelling in the right metacarpophalangeal and right shoulder joints.

An 82-year-old woman complains that for the past 6 months, she has "not felt like herself." Previously, she was very active and energetic; in fact, 9 months earlier, she had vacationed in Hawaii. It now takes all of her energy just to get out of bed.

MRSA is the second most common pathogen isolated in the ICU setting, associated with 52.9% of nosocomial infections.1 Colonization of patients with S aureus (methicillin-sensitive and methicillin-resistant) has been found to be important for the development of subsequent infections, including bacteremia.2-4 The primary reservoir of S aureus in humans is the anterior nares and, to a lesser extent, the perineum and skin.5,6 As a result, topical antibiotics and antiseptics have been used to eradicate colonization in a variety of patient populations in an effort to prevent infection and to control transmission of MRSA.

Is it prudent to prescribe an oral bisphosphonate for an elderly woman with osteoporosis who has had acute hemorrhaging from a lower colonic diverticulum, for which a transfusion of 3 units of packed red blood cells was required?

While spending a month in Cuba, my travel companion experienced seabather's eruption, which was described by Drs Mary Sy and Gary Williams in their Photo Essay "The Dermatologic Perils of Swimming"