Psoriasis is the most common autoimmune disease. Other skin conditions might seem like psoriasis, so ruling out the look-alikes is important. This compact slide show provides visual presentations of various lesions.
Oral lesions, often the harbingers of early HIV infection, rank among the most common complaints for which HIV-positive patients seek primary care. This compact slide show provides visual presentations of these and other lesions associated with HIV.
ASH is the largest organization of hypertension researchers and health care providers in the United States committed to preventing and treating hypertension and its consequences. The editors of ConsultantLive bring you updates from the 2013 ASH conference in San Francisco, CA. Read More
More than 1300 physicians of all specialties responded to the 2012 survey. Many of the respondents are primary care physicians. See how your colleagues responded and learn what concerns them most.Read more
ABSTRACT: The main therapeutic goals for patients who have an acute coronary syndrome are to reestablish normal epicardial flow and to increase distal myocardial perfusion. Fibrinolytic treatment with tissue plasminogen activator within 70 minutes of the onset of symptoms dramatically reduces the mortality rate from myocardial infarction. Other fibrinolytic agents include reteplase, which is given as a double bolus, and tenecteplase, which is given as a single bolus. In most hospitals, fibrinolytic therapy is more readily available than percutaneous transluminal coronary angioplasty (PTCA); however, PTCA may be the preferred approach if it is available within an hour and a half. Antiplatelet drugs, such as glycoprotein IIb/IIIa receptor antagonists, are used to improve distal myocardial perfusion. If follow-up coronary angiography is not available to assess whether epicardial blood flow and distal myocardial perfusion have been restored, a 12-lead ECG can provide valuable information. The resolution of ST-segment abnormalities is a marker for improved perfusion.
ABSTRACT: Unless the cause of back pain is obvious, order anteroposterior and lateral radiographs of the spine, a complete blood cell count, erythrocyte sedimentation rate, and urinalysis. If you suspect infection, tumor, or bony abnormalities, obtain an MRI or CT scan. MRI has surpassed bone scanning as the gold standard for diagnosing spinal infections, because it confirms a specific anatomic diagnosis. Spondylolysis and spondylolisthesis are 2 of the most common causes of back pain in adolescents; the diagnosis is made with plain radiographs, which show slippage on the later-al view in patients with spondylolisthesis and fracture through the pars interarticularis on the oblique views in those with spondylolysis.
The most common blood-borne infection in the United States, hepatitis C is also one of the leading causes of chronic liver disease in this country. About 35,000 new hepatitis C virus (HCV) infections are diagnosed each year; by 2015, the number of persons with documented HCV infection is expected to have increased 4-fold from what it was in 1990.
In the United States, osteoporosis affects 12% to 28% of women over age 65 years. Among women who live to be 85, 50% will sustain an osteoporosis-related fracture. Hip fractures occur in 15% of these women, and vertebral deformities develop in 25%
ABSTRACT: Patients can greatly reduce the risk of traveler's diarrhea by drinking only bottled water and eating only hot foods prepared in sanitary conditions or peelable fruits and vegetables. Antibiotic prophylaxis for traveler's diarrhea is no longer routinely recommended; reserve it for patients who may have to consume food and beverages of questionable safety, those with reduced immunity, and those likely to experience serious consequences of illness. Adequate hydration is the first step in treating traveler's diarrhea. Drug therapy-loperamide or fluoroquinolones in adults and bismuth subsalicylate or azithromycin in children-can ameliorate symptoms and speed recovery. Recommend that patients who are prone to motion sickness take an antiemetic/antivertigo agent before symptoms begin. Acetazolamide can be used both to prevent and to treat altitude sickness. Contraindications to air travel include a resting oxygen saturation of less than 90%, pregnancy of more than 36 weeks' duration, pneumothorax, recent myocardial infarction or chest or abdominal surgery, active infectious diseases, and poorly controlled seizures or sickle cell anemia.
States.1Nearly 3 million
persons have the disease,
and about 100,000 new
cases are diagnosed each
year.1 Between 3 and 6 million
Americans are thought
to be at increased risk for
glaucoma because of elevated
A 78-year-old man presented to the
emergency department with a 3-week
history of progressive shortness of breath
and cough with blood-streaked, yellowish
sputum. The patient had dyspnea on
exertion limited to 2 blocks, 2-pillow
orthopnea, paroxysmal nocturnal dyspnea,
and nocturia. Neither fever nor
chills were present. He had lost 7.2 kg
(16 lb) during the last year.
Smoking-related diseases have reached epidemic levels
among women in the United States. Since 1980, neoplastic,
cardiovascular, respiratory, and pediatric diseases attributable
to smoking—as well as cigarette burns—have
been responsible for the premature deaths of 3 million
American women and girls. Lung cancer is now the leading
cause of cancer-related deaths among US women; it
surpassed breast cancer in 1987.1
Calcium channel blockers
are commonly prescribed
to treat several
and may be helpful in
other conditions, such as migraine
and bipolar disorder.1 These agents
are associated with numerous clinically
significant drug interactions.1-3
While some of these interactions,
such as the effect of verapamil on
serum digoxin concentrations, are
well-known, others are not widely recognized—
yet warrant attention.
A 77-year-old man is brought to the emergency department after several
days of illness that began with fever, nausea, emesis, and headache. Muscle
weakness and associated myalgia developed; the weakness became so severe
that the patient needed help to get out of bed and walk to the bathroom.
The day before he came to the hospital, he slept much of the time and was
difficult to arouse.
The ConsultantLive.com podcast archive includes the series Cardiology Now—discussions between Dr Payal Kohli of the University of California San Francisco and experts in cardiovascular medicine including Drs Christopher Cannon, Deepak Bhatt of the TIMI study group at Harvard and Dr Roger Blumenthal, Director of the Ciccarone Center for the Prevention of Heart Disease at Johns Hopkins. See More Multimedia »
Featured in this section are short videos of practical dermatology webinars given by Dr Ted Rosen, Professor of Dermatology at Baylor College of Medicine and Chief of the Dermatology Service at the Veterans Affairs Medical Center, both in Houston, Texas. Each segment offers concise, practical clinical guidance on a specific dermatologic condition seen frequently in primary care. See More Multimedia »
Diagnostic Champions’ Challenge on Consultant Live Test your diagnostic skills and knowledge by quickly identifying and assessing various mental health disorders. The Psychiatric Times Diagnostic Champions' Challenge is meant to educate and entertain. Test your clinical acumen in this activity that is sure to make you think.…
Our “one and done” approach to helping patients change entrenched behavior is a bit like making pock-marks on a mountain and saying we moved it. I long for clinical systems that tap the geophysical energy of time and persistence.