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Educating Patients and Providers: Key Takeaways for Better VMS ManagementPanelists discuss how providers should actively screen for vasomotor symptoms (VMS), especially given the lengthy wait times to see specialists, emphasizing that education for both patients and health care providers is essential for timely intervention and effective management.
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The Complexities of Treating Rosacea, with Benjamin Ungar, MDBenjamin Ungar, MD, explains the phenotypic and molecular manifestations of Rosacea, and the work still needed to develop targeted treatments.
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Closing Thoughts on the Treatment of MDDRoger S. McIntyre, MD, FRCPC, and Carmen Kosicek, MSN, PMHNP-BC, discuss the future of MDD treatment and share closing thoughts.
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Patient Selection for Teplizumab and Infusion ProcessPanelists discuss how patient selection for teplizumab therapy requires careful screening for autoantibody positivity and preserved C-peptide function, followed by a 14-day outpatient infusion process that needs close monitoring for cytokine release syndrome and other potential adverse effects.
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Final Thoughts on Identifying and Managing Patients with T1DPanelists discuss how early identification of Type 1 diabetes through screening programs, combined with emerging therapies like teplizumab, offers new opportunities for intervention and improved patient outcomes in at-risk populations.
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Closing Thoughts with Patient Cases: Disease Control With Modern TherapiesA panelist discusses how contemporary therapeutic approaches enable successful management of atopic dermatitis through examination of real-world patient cases that demonstrate effective disease control strategies using the latest treatment options.
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Refining Diabetes Care for Older Adults: Expert Insights on Deprescribing, Streamlining Treatment, and Key Practice PearlsExperts on diabetes provide insights gleaned from the SIMPLE study and outline patient factors that inform treatment decisions.
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Key Insights and Final Thoughts on Screening and Management of T1DPanelists discuss key insights on the importance of early screening for T1D, the role of antibody testing in identifying at-risk individuals, and the need for timely intervention to preserve ß-cell function and optimize long-term management strategies for better patient outcomes.
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FDA's First Draft Guidance on Clinical Trials with Psychedelic Drugs Now Available for CommentThe FDA's recommendations serve to inform potential research sponsors on development protocols for psychedelics and to solicit comment from industry.
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Tips for Safe Post-Pandemic Telehealth UseBeware the potential pitfalls of telemedicine, from privacy concerns to patient confusion, says associate general counsel for The Doctors Company.
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Clinical Implications of Off Target TSH Levels and Importance of Patient Education in Managing HypothyroidismEndocrinology experts discuss the clinical implications of off-target TSH levels and stress the importance of stabilizing these levels for hypothyroidism management.
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CDC Endorses GSK, Pfizer RSV Vaccines for Older AdultsThe 2 new vaccines are authorized for adults aged 60 years and older and with CDC Director Walensky's final nod, should be available this fall.
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Key Takeaways for the Management of MDDCarmen Kosicek, MSN, PMHNP-BC; Charles Montano, MD; and Gus Alva, MD, DFAPA, provide take-home messages for the management of patients with MDD and other depressive disorders.
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Key Insights and Practical Tips: Wisdom from UCSD Practitioners for Effective T1D ManagementThe panel of experts from UCSD concludes the discussion on delaying the onset of stage 3 T1D by providing key takeaways and clinical advice on the treatment of patients with this condition.
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Why all patients with asthma do not require controller therapyAbstract: Although controller therapies are currently recommended for patients who have persistent asthma, a number of studies indicate that these therapies do not adequately control asthma in a substantial number of these patients. This observation, combined with the potential risk of adverse effects with corticosteroids, supports the conclusion that controller therapies are not appropriate for all patients. However, some patients who do not respond to one type of controller therapy will respond to another, which suggests that we might consider targeting specific medications to select patients. There is increasing evidence that certain biomarkers may be useful in guiding therapy. For example, levels of sputum eosinophils have been shown to predict which patients are at increased risk for deterioration of asthma when inhaled corticosteroids are withdrawn.
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Man With Prosthetic Valve Who Needs GI SurgeryA 68-year-old man with a prosthetic mitral valve presents to the emergency department with acute abdominal pain, nausea, vomiting, and constipation. Surgical evaluation is performed; the results suggest a complete bowel obstruction. Urgent celiotomy is recommended.
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Cecal Volvulus at an Unusual AgeFor the past 2 hours, a 19-year-old man had lower abdominal pain accompanied by nausea and vomiting. He had no fever and no diarrhea. Direct tenderness was mainly in the right lower quadrant, radiating slightly to the left lower quadrant. There was no significant rebound tenderness. The patient refused rectal examination.
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Lower Quadrant Pain and Emesis in a Young BoyThe 9-year-old was admitted after 1 day of symptoms; he had no fever, diarrhea, constipation, dysuria, or rash. More details here. What's your diagnosis?
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A patient with Cushing syndrome and reduced lung volumesWe present a rare case ofCushing syndrome resultingfrom thymic carcinoid of thelung. Although Cushing syndromeis not usually associatedwith respiratory muscleweakness or restriction, ourpatient had reduced lung volumesand expiratory muscleweakness. His reduced lungvolumes could not be completelyexplained by respiratorymuscle weakness, parenchymallung disease, or obesity.Six months after removal ofthe carcinoid tumor, the patient'sgrowth hormone leveland the lung volumes improvedsignificantly, and hebecame asymptomatic.
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Metastatic Melanoma in an 83-year-old ManAn 83-year-old man with a history of hypertension and coronary artery disease presented with a 4-day history of mental status changes, slurred speech, and difficulty ambulating. He reported a lack of appetite and weakness of several days.
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Visual Hallucination: Charles Bonnet SyndromeCharles Bonnet syndrome is an uncommon condition causing visual hallucination in patients who do not have mental illness
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Inflammatory Breast CancerA 40-year-old woman was concerned about an area of redness and tenderness on her left breast. Despite antibiotic therapy prescribed by another physician, the rash had progressed during the past month to erythema and nodules that involved the anterior chest and right breast.
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Chylothorax After Debridement of Necrotizing FasciitisA 38-year-old woman with a history of injection drug use presented with progressive pain in the left arm and neck and fever.
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A case of progressive shortness of breath in a patient with emphysemaA 71-year-old man who had received a diagnosis of emphysema 12 years ago was referred by his primary care physician to the pulmonary clinic. His symptoms were well controlled until a few months ago, when he complained of mild shortness of breath on physical activity. However, the shortness of breath worsened and became a significant limiting factor. He also had a persistent dry cough.
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MAC Infection in a Man With Pectus ExcavatumFor 6 weeks, a 56-year-old man had worsening dyspnea on exertion and a cough productive of yellow sputum with scant hemoptysis. He reported subjective fever over the past month but no weight loss.
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Removing Fishhook From FingerA 3-year-old boy was at home with his cousin who was preparing for a fishing trip when a fishhook accidentally became lodged in the distal part of the child's right middle finger. There was mild erythema and swelling, with tenderness on palpation. No bleeding or discharge was noted. The patient had full range of motion, with normal sensation and capillary refill. Remaining examination findings were unremarkable. Radiographic views of the affected area confirmed the absence of bony infiltration.
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Disseminated CandidiasisA 72-year-old morbidly obese man who had diabetes mellitus was admitted to the hospital from a nursing home with a fever of 4 days' duration. A tracheostomy had been performed 3 months earlier for respiratory failure. The patient was being treated with corticosteroids for chronic obstructive pulmonary disease.
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Eczema Herpeticum in a 4-Year-Old GirlThis diagnosis is a relative dermatologic emergency; presumptive treatment with antivirals should at least be considered if any suspicion exists.
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Lisfranc Ligamental InjuryAfter a fall during a soccer match 2 weeks earlier, a 26-year-old woman had pain of the right midfoot, with moderate swelling. The pain was aggravated with a normal gait and alleviated with an antalgic gait, specifically with inversion of the right ankle such that most of the weight from heel-strike through toe-off transmitted forces from the lateral calcaneus through the fifth metatarsus to the fifth phalanx.
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Middle-aged Hiker With Facial ParalysisA 46-year-old man presents with right-sided facial paralysis. His symptoms beganthe previous evening when he had difficulty in closing his right eye; by morning,paralysis had developed. He also reports headache and mild photophobia.
