October 31st 2024
ACG 2024: New study results indicate GLP-1 RAs have a potentially protective role to play in combating EO-CRC, the incidence of which is notably rising worldwide.
October 10th 2024
Breast-Size Paired Bumps on the Back of an Old Man
October 2nd 2008A 93-year-old man with known Alzheimer dementia has his admission physical examination on transfer to a geropsychiatric hospital unit due to behavioral difficulties. A language barrier and his stoicism minimize communication, but his devoted wife translates and recounts that he is not in any physical discomfort. Has sometimes needed oxygen treatment in the past.
Drug Interactions That Decrease Levothyroxine Efficacy
October 2nd 2008Levothyroxine is one of the most commonly prescribed medications for the treatment of hypothyroidism as well as the suppression of thyroid neoplasms.1 Most patients with hypothyroidism require lifelong therapy with levothyroxine; therefore, the likelihood of drug interactions is high.
Non-HDL Cholesterol: When-and How-to Treat
September 2nd 2008Over the past 4 decades, our understanding of the role of elevated cholesterol in cardiovascular disease (CVD) has undergone radical change. During that time, we have moved from a belief that cholesterol does not matter and that atherosclerosis is an irreversible process to a strong conviction that treating elevated cholesterol, especially elevated low-density lipoprotein cholesterol (LDL-C), can slow and perhaps halt the progression of atherosclerosis. But it has been a slow process for several reasons. In the 1960s, the Framingham investigators demonstrated that elevated serum cholesterol is a risk factor for CVD.1
Serratia marcescens Pneumonia in an HIV-Infected Patient
August 2nd 2008For 3 days, a 45-year-old woman with HIV infection who was noncompliant with her antiretroviral medications had cough, yellowish sputum, fever, and dyspnea. She denied hemoptysis, weight loss, or recent hospitalization. She had a long history of heavy smoking and alcohol and intravenous drug abuse.
Woman With Fever, Hoarseness, and a Half-Swollen Face
July 1st 2008A 55-year-old woman seen because of new lump under right side of her jaw; present for 24 hours. Associated neck discomfort causing dysphagia, and also a raspy turn to the voice; both much worse in last 12 hours. No dyspnea. No sore throat.
A Risk-Based Approach to the Care of Survivors of Childhood Cancer: 3 Case Studies
May 2nd 2008Survivors of childhood cancer frequently present to primary care practitioners for a routine physical examination or for urgent care. Knowledge of the patient's cancer history and of the specifics of the treatment are essential to providing proper care and addressing his or her unique risks.
Screening for Vascular Disease in a Former Smoker
May 2nd 2008As part of his preparation for retirement, a 66-year-old executive undergoes a complete physical examination. He is in good health and has no symptoms to report. Along with other age-appropriate screening studies, you discuss testing for vascular disease with him.
Chronic Pain Syndromes: How to Break the Cycle, Part 1
April 2nd 2008Pain is a significant public health concern. In a prevalence study conducted in Australia, 17% of men and 20% of women reported chronic daily pain. A US study found that 13% of the total workforce had lost productive time during a 2-week period because of a pain condition. Headache, back pain, and arthritis pain headed the list of causes.
Treatment of Sleep Apnea: To Cut May Not Always Be To Cure
March 2nd 2008How effective is upper airway surgery in treating obstructive sleep apnea? The fallout from the growing obesity epidemic includes obstructive sleep apnea (OSA) syndrome. Although OSA may be considered a "specialty disease" (managed by pulmonologists, sleep specialists, otolaryngologists, and bariatric surgeons), the primary care physician bears the brunt of providing ongoing care.
Systolic Hypertension: A Guide to Optimal Therapy
March 2nd 2008Systolic hypertension is an independent risk factor for coronary artery disease, stroke, and end-stage renal disease. Nonpharmacological interventions for systolic hypertension include limitation of dietary sodium and alcohol intake along with weight reduction and aerobic exercise.
Ruptured Abdominal Aortic Aneurysm
February 1st 2008An obese 61-year-old man with a history of heroin abuse was brought to the hospital after he had fallen onto his buttocks on a sidewalk. He was able to stand initially, but weakness and numb-ness in his legs rendered him suddenly unable to walk or prevent himself from voiding. He denied abdominal or back pain. His medical history included asthma, chronic obstructive pulmonary disease, and hypertension.
Managing the Patient With an Abnormal Liver Test: Part 1, Persistent Aminotransferase Elevations
December 1st 2007Identifying the cause of a persistent, asymptomatic aminotransferase elevation can be challenging. The possible diagnoses are many and varied. To narrow the differential, begin with a detailed history.
Diabetes: A Primer on New Drug Options
November 1st 2007Over the past 20 years, the treatment armamentarium for diabetes has greatly expanded: 8 different classes of non-insulin drugs and 8 different types of insulin are now available. The newer classes of agents include disaccharidase inhibitors, thiazolidinediones, meglitinides, glucagonlike peptide analogs, and dipeptidyl peptidase IV inhibitors.