May 21, 2013
Top 10 Common Medication Errors—Drug #9: ClonidineMay 21, 2013
After taking a few doses, the boy became extremely lethargic. He was seen at the clinic and was found to be hypotensive and was admitted to a nearby hospital. What was the problem?Full Story »
Physician, First Do No Harm—To YourselfMay 20, 2013
At a recent retreat I led for doctors on the brink of total burnout, all hands went up when I asked if anyone had lost a colleague to suicide. All but one hand was raised to confirm having considered their own suicide. Many in the room had signed up for this weekend hoping to learn how to avoid becoming the colleague behind someone else's raised hand.
A Requiem for Beta Blockers to Treat Hypertension?May 20, 2013
At the ASH meeting, one could get a pretty good sense of where the beta blocker hypertension debate is headed.Full Story »
A Future of Beta Blockers “Plus” to Treat Hypertension?May 20, 2013
The “plus” means beta blockade plus a little something more – like alpha blockade, or generation of nitric oxide. From ASH 2013, a glance toward the future. .Full Story »
CPAP Therapy for Obstructive Sleep Apnea Improves Levels of Inflammatory BiomarkersMay 20, 2013
C-reactive protein, tumor necrosis factor-alpha, and interleukin-6 are associated with the development of atherosclerotic disease. If CPAP reduces CV disease, does it also reduce these precursors?Full Story »
Tuberculosis Diagnosis With Handheld DeviceMay 17, 2013
New technology can rapidly diagnose TB and other important infectious bacteria, as well as determine the presence of antibiotic-resistant bacterial strains.Full Story »
Pectoralis Major Agenesis (Amyoplasia)May 17, 2013
This man's right chest shows partial absence of the pectoralis major muscle—part of Poland syndrome, which consists of which anomalies?
Making the Most of Antihypertensive Drug CombinationsMay 16, 2013
The number of people who require 2 or more antihypertensives to reach target blood pressure are on the increase. So, simply stated, what goes best with what? The 2013 ASH meeting offered some good suggestions under the heading of “Within Class Differences.”Full Story »
Men’s Health Issues—A Photo EssayMay 16, 2013
The top men's health concerns include heart disease, cancer, accidents, and chronic lower respiratory diseases. This compact slide show provides visual presentations of other clinical problems that pose a threat to men and that might be seen in primary care practice.
Hypertension and the Brain: More to the Story Than StrokesMay 16, 2013
At ASH 2013 in San Francisco, a troubling central nervous system complication of untreated hypertension was discussed—dementia. To infer that CNS damage is a correlate of vascular dementia is only partially correct. For primary care physicians, the rest of the story is a must-read.Full Story »
Some Do’s and Don’ts for Tough-to-Treat HypertensivesMay 16, 2013
Patients with resistant hypertension and hypertensive patients prone to hyperkalemia are on the rise. They are not easy to care for, but certain “tricks of the trade” can help. Details here.Full Story »
Filling Gaps in Hypertension Rx: Sleep Disorders and StrokeMay 15, 2013
ASH 2013 has uncovered 2 glaring gaps in the management of people with sleep disorders (OSA as well as others) and appropriate care after a stroke. Both cohorts frequent primary care practice.Full Story »
Go For The Glory Quiz: Foreign Body Aspiration; Persistent Snoring; Daily Dark Chocolate; Suspicious Pigmented Macule; Diabetic KetoacidosisMay 15, 2013
Test your clinical skills in this week’s 5-question quiz.
When the CHADS2 Score = 1: Will Aspirin Do or Is Warfarin Indicated?May 16, 2013
For a patient with atrial fibrillation whose risk of ischemic stroke is low, is antiplatelet therapy the right choice? A revised risk calculation formula, based on the original CHADS2 criteria, restratifies low-risk patients to further help identify those who may not require oral anticoagulation.Full Story »
Taking Alzheimer Research Down New Protein PathsMay 15, 2013
Researchers have devoted themselves to devising ways of blocking the production or accumulation of beta-amyloid. Now scientists are studying other protein targets, including tau.Full Story »
Eplerenone Reduces Atrial Fibrillation Incidence in Heart Failure PatientsMay 15, 2013
How aldosterone antagonism achieves this reduction is uncertain, but the study highlights this class as an important treatment option to consider in patients with HF and AF.Full Story »
Hypertension Meeting Has Primary Care TrackMay 16, 2013
The goals at the 2013 scientific meeting of the American Society of Hypertension, which began on Wednesday, May 15 in San Francisco, are to increase understanding and, perhaps, find a cure.Full Story »
DermatophytosisMay 15, 2013
This solitary, very pruritic, annular lesion suggests dermatophytosis. KOH preparation verified the presence of Tinea faciei. This infection is usually associated with contact with a new kitten or puppy.
Oro-labial Herpes Simplex (“Cold Sores”)
This clustered grouping of small, shallow erosions surmounting a slightly indurated plaque is characteristic for “cold sores.” Because no vesicles were present and the lesions appeared to be crusting over, the patient was advised to apply an OTC cream (docosanol 10%) per package insert instructions.