For all the (justified) apprehension about health care reform, the current momentum offers a rare opportunity to reorient the health care system around health and wellness. One of President Obama’s 8 principles for health care legislation is that it must invest in prevention and wellness. Education is needed on how to eat healthy and maintain wellness through disease prevention and early detection, with such efforts supported by physicians, health plans, employers, and the government. Changes are also needed in health plan design and physician education to support a new prevention/wellness paradigm. Possible areas of focus include:

It was the best of times, it was the worst of times.

It results from reactivation of latent varicella-zoster virus (VZV) within the

This lesion had appeared in the right groin of a 60-year old man and had slowly enlarged over a month (A). Two years before this evaluation, he had undergone total prostatectomy with lymph node dissection for prostate carcinoma. Metastatic disease was found in a resected lymph node, and he underwent multiagent chemotherapy.

The patient is a 54-year-old man, a native of Poland who has lived in the United States for many years. A diagnosis of AIDS was made in 1994, when Hodgkin disease (nodular sclerosing Hodgkin lymphoma) was found in an enlarged cervical lymph node and he tested positive for HIV during his workup.

The 1990s were an exciting decade for the treatment of chronic kidney disease (CKD). The addition of angiotensin-converting enzyme inhibitors (ACEIs) and then angiotensin receptor blockers to the antihypertensive armamentarium helped preserve renal function and decrease proteinuria in patients with CKD.

In a recent AIDS Reader editorial, Joel E. Gallant called for clinicians who treat persons with HIV/AIDS to “become vocal advocates for routine HIV screening,

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How often has this happened to you? You are searching online for the answer to a clinical question, and you find what looks like a promising article. But when you try to access the article on the journal’s Web site, a message pops up stating that a subscription or payment is required.

It seems that every mother operates from a standardplaybook.

An all-terrain vehicle-ATV-is described by the American National Standards Institute as one that "travels on low pressure tires, with a seat that is straddled by the operator, and with handlebars to be used for steering."1 By this definition, an ATV is designed for interactive riding by a single operator. Drivers are able to shift their weight freely in all directions depending on the situation and terrain. According to ATV safety standards and recommendations, children younger than 6 years are never to be on an ATV of any size-alone or with someone else.

Prolonged exposure to high-risk strains of human papillomavirus (HPV) and the dysplastic effects that HPV exerts on cells of the squamocolumnar transitional junction of the anal canal lead to anal intraepithelial neoplasia (AIN), which is a precursor to squamous cell carcinoma of the anus (SCCA).1 Anal HPV infection is present in 93% of HIV-positive men who have anoreceptive intercourse.2 Furthermore, anal dysplasia of any grade has been reported in 56% of HIV-infected men who participate in anoreceptive intercourse.3,4

Anal cancer has become one of the most common non–AIDS-defining tumors in HIV-infected persons.1,2 The incidence of anal intraepithelial neoplasia (AIN) is also markedly increased in HIV-positive men,3 particularly those who have sex with men (MSM), despite the introduction of highly active antiretroviral therapy.4

Physicians are failing to diagnose HIV infection among older patients,

Researchers have identified 2 gene variations that are resistant to interferon ß therapy. This finding could lead to a biomarker for determining when IFN-ß is appropriate for the treatment of multiple sclerosis.

Prevalence of migraine is higher in men and women who have total body obesity (TBO) or abdominal obesity (Abd-O), according to the results of a study by Lee B. Peterlin, DO, assistant professor in the Department of Neurology, and colleagues at Drexel University College of Medicine in Philadelphia.

As Indiana native John Mellencamp might say, “Ryan White was born in a small town.” Kokomo, Ind, in 1971 indeed was a thriving, relatively small community in America’s Heartland. A town founded on family values, hard work, and a full belief in the American Dream,

Health care reform, the patient-centered medical home, and the impact of environmental change on global health are just a few of the topics to be discussed at the Internal Medicine 2009 Medicine 2009 in Philadelphia this week.

Nearly one-fifth (19%) of US employers are taking steps to discontinue providing health care benefits during the next 3 to 5 years, up from just 4% in 2008, according to results of The Road Ahead: Emerging Health Trends 2009, a survey conducted for Hewitt Associates by project leader Jeffrey D. Munn. The team interviewed benefit executives at 343 large employers representing more than 5 million employees in December 2008 and January 2009.

An estimated 5 million US adults, or about 2% of the adult population, have fibromyalgia (FM), according to 2005 data collected by the National Arthritis Data Workgroup (Figure 1). FM is a chronic condition of unknown etiology characterized by widespread muscle pain, sleep disturbance, fatigue, and often psychological distress and is considered a form of arthritis. The workgroup also reported that the only study on the prevalence of primary FM in the United States-which included 3006 adults 18 years and older-showed that prevalence was significantly higher among women than among men (3.4% vs 0.5%; approximately a 7:1 ratio). In women, prevalence of the condition rose sharply in middle age, to 7.4% among those aged 70 to 79 years, and then declined. Prevalence of FM in men similarly peaked between 70 and 79 years but was only slightly more than 1% among men in this age-group. The CDC notes that the condition can also develop in children.