Benign skin lesions can arise in the outer ear as easily as in any other body part frequently exposed to the sun. Seborrheic keratosis may mimic malignant melanoma but is innocuous. Actinic keratosis is premalignant and should be excised, biopsied, and the site of excision monitored vigilantly.
These innocuous lesions of the outer ear may arise spontaneously or after trauma or surgery. Both auricular seroma and pyogenic granuloma usually resolve satisfactorily after minor surgery, though they may recur.
Diagnostic challenge: Two case reports of easily treated and innocuous causes of lesions in the outer ear. Chondrodermatitis nodularis helicis is associated with long cellphone use. Verruca vulgaris is caused, like all other warts, by human papillomavirus.
Contrast-enhanced ultrasounds are an effective complementary tool in following up patients who undergo endovascular repair for abdominal aortic aneurysm. More »
An older woman was admitted with progressive shortness of breath and generalized weakness. The patient had a past medical history of hypertension, congestive heart failure (CHF), and hypercholesterolemia. More »
How much longer will it remain necessary to invade a blood vessel in order to detect and measure a blockage? Intravascular ultrasound is a popular candidate for noninvasive diagnosis, but some experts in diagnostic imaging are using light beams rather than sound waves for the search. More »
Patients with type 2 diabetes should be receiving statin therapy, but many patients who would benefit from these agents are not taking them—and not reaching target lipid levels. A recent study shows that timing of statin initiation can make a difference. Here to put the issue into perspective... More »
Oral nifedipine and intravenous labetalol show similar efficacy in their ability to control hypertensive emergencies of pregnancy, according to new research published in BJOG: An International Journal of Obstetrics & Gynaecology. More »
Researchers revisit the question in an observational study, concluding that beta blockers do not increase these risks and should not be withheld from people who have both heart failure and type 2 diabetes. More »
Patient who have had a hip prosthesis operation (and many others) habitually rotate their legs outward. Devices such as shoes with outriders either fail to keep them rotated inwardly or cause pressure sores on the feet. More »
A 39 year-old female with Turner Syndrome completely asymptomatic in the previous years, presented to our department with recent onset of dizziness and fatigue.
An 18-year-old woman with no known medical history presented to the ED complaining of fever, chills, and rigors of a week’s duration. The patient appeared very ill with hypotension, tachycardia, tachypnea, and fever.
22533587 2012 04 26 2012 04 27 1533-4406 366 17 Apr 26 N. Engl. J. Med. 1641; author reply 1642-3 Coupland Carol C Hippisley-Cox Julia J Brindle Peter P eng Comment Letter United States N Engl J Med 0255562 0028-4793 AIM IM N Engl J Med. 2012 Jan 26;
Synthetic arteriovenous grafts, an important option for hemodialysis vascular access, are prone to recurrent stenosis and thrombosis. Supplementation with fish oils has theoretical appeal for preventing these outcomes.|To determine the effect of fish oil on synthetic hemodialysis graft patency and cardiovascular events.|The Fish Oil Inhibition of Stenosis in Hemodialysis Grafts (FISH) study, a randomized, double-blind, controlled clinical trial conducted at 15 North American dialysis centers from November 2003 through December 2010 and enrolling 201 adults with stage 5 chronic kidney disease (50% women, 63% white, 53% with diabetes), with follow-up for 12 months after graft creation.|Participants were randomly allocated to receive fish oil capsules (four 1-g capsules/d) or matching placebo on day 7 after graft creation.|Proportion of participants experiencing graft thrombosis or radiological or surgical intervention during 12 months' follow-up.|The risk of the primary outcome did not
22153196 2011 12 14 2011 12 29 1474-547X 378 9808 Dec 10 Lancet 1993; author reply 1994 Taylor Rod R Hooper Lee L Ebrahim Shah S eng Comment Letter England Lancet 2985213R 0140-6736 0 Sodium Chloride, Dietary AIM IM Lancet. 2011 Jul 30; 378( 9789):
Based on repeated measurement of health behaviors the CroHort Study showed that health behavior explains a great deal more of class inequalities in mortality than observed in previous studies. These include decreasing prevalence of smoking and increase in obesity, hypertension and diabetes mellitus. The lowest prevalence of health risks was recorded among children and adolescents, followed by general adult population from the CroHort Study. Hospitalized coronary heart disease patients had higher risks prevalence than general population, while the highest prevalence of risks was recorded among patients in cardiac rehabilitation program. The higher levels of stress were associated to lower financial conditions, poorer social functioning and poorer mental health for both men and women. Higher levels of stress were also associated with heart problems, higher alcohol consumption in men while in women stress was associated to poorer general health, higher age and lower levels of education.
Previous studies have documented that Fc receptor III A of immunoglobulin G (FcRIIIA, also named CD16) is involved in the development of coronary heart disease (CHD). However, the mechanism responsible for FcRIIIA's in contribution to CHD development remains largely unclear. Herein, we investigated the possible role of FcRIIIA in the development of atherosclerosis. Our results showed that the elevated level of FcRIIIA on monocytes closely correlated to the adhesive efficiency of human umbilical vein endothelial cells (HUVECs) in vitro. Importantly, we also observed increased population of CD16(+) monocytes and elevated CD16 level on monocytes in ApoE(-/-) mice with characterized atherosclerosis after feeding with high-fat diet for 10weeks. The enhancement of CD16 on monocytes closely correlated to increased content of MMP-9 in aorta and increased inflammatory cytokines in sera. In addition, similar to simvastatin, recombinant human M-CSF represented a robust inhibitory
Physician Performance Goals Are Great, But Balance Is More Realistic Jennifer Frank, MD, May 15, 2012 Performance measurements for physicians are well-intentioned and get me to rethink how I practice. But in the end I won't make the goals, so I'll have to go with balance over perfection.
Designing the Perfect Business Card for Your Medical Practice C. Noel Henley, MD, May 11, 2012 Does your business card say anything substantive about the valuable work you do in your practice? Here’s how to re-design your next business card for maximum impact and engagement.
Registered Nurses an Ideal Fit for Primary Care Practices Audrey "Christie" McLaughlin, RN, May 10, 2012 Here are four good reasons to hire a registered nurse for your primary care practice …maybe even instead of a medical assistant.
The Five Biggest Medical Practice Marketing Mistakes James Doulgeris, May 10, 2012 There are best practices to marketing your practice, but often, success is more about knowing what not to do. Here are the five most common pitfalls …and how to avoid them.
Can You Practice Medicine and Manage Your Practice? Rosemarie Nelson, May 9, 2012 Whether you practice alone, or in a group, if you're trying to see patients in this pay-for-volume environment and also run the business of your practice, you may be missing out on important opportunities.
Evid Based Mental Health. 2012; 15: 43 doi: 10.1136/ebmental-2011-100514. Prognosis. Use of ADHD drugs in children and young adults does not increase risk of serious cardiovascular adverse ... Are children and young adults using attention deficit
Evid Based Med. doi: 10.1136/ebmed-2012-100677. Therapeutics. Randomised controlled trial. The legacy effect: 4.5 years of a chlorthalidone-based antihypertensive regimen reduces cardiovascular mortality and prolongs cardiovascular ... disease-free
More than a decade ago, cardiovasculardisease (CVD) was recognized as a major cause of death in children with advanced CKD. This observation has sparked the publication of multiple studies assessing cardiovascular risk, mechanisms of disease, and early markers of CVD in this population. Similar to adults, children with CKD have an extremely high prevalence of traditional and uremia-related CVD risk factors. Early markers of cardiomyopathy, such as left ventricular hypertrophy and dysfunction, and earl
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Benign skin lesions can arise in the outer ear as easily as in any other body part frequently exposed to the sun. Seborrheic keratosis may mimic malignant melanoma but is innocuous. Actinic keratosis is premalignant and should be excised, biopsied, and the site of excision monitored vigilantly. 
These innocuous lesions of the outer ear may arise spontaneously or after trauma or surgery. Both auricular seroma and pyogenic granuloma usually resolve satisfactorily after minor surgery, though they may recur. 
Diagnostic challenge: Two case reports of easily treated and innocuous causes of lesions in the outer ear. Chondrodermatitis nodularis helicis is associated with long cellphone use. Verruca vulgaris is caused, like all other warts, by human papillomavirus. 
Findings of the TIPS-2 study, announced at the recent 2012 World Congress of Cardiology, put the promise of the polypill—a... 
The Vivid E9 Breakthrough 2012 includes a 4-D transducer for transesophageal echocardiography,... 
An 18-year-old woman with no known medical history presented to the ED complaining of fever, chills, and rigors of a week’s duration. The patient appeared very ill with hypotension, tachycardia, tachypnea, and fever. 
A 48-year-old African-American man with no significant medical history sustained a gunshot wound to the face and shoulder.
