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CME/CE
Back Pain in a 39-Year-Old Man from Guatemala
A 39-year-old Guatemalan man presents to the ED with severe and debilitating back pain. He has been previously evaluated for his back pain twice in the past few weeks. The pain is throbbing and diffuse throughout the lower back, with radiation to his left buttock and upper back, and it has been progressively worsening. Mild tenderness to palpation is noted in the midline lower back. A lumbar radiograph and a magnetic resonance imaging scan of the spine are obtained. What is the diagnosis?
Clinical Case, May 2008
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Do Immigrants Help or Hurt US Healthcare?
Patients are not the only critical piece of the equation. A Web site that examines hot business topics in medicine offers an unusual perspective on this and other issues.
Article, May 2008
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CME
Importance of Surgical Margins in the Management of Renal Cell Carcinoma
Partial nephrectomy is more commonly used for renal cell carcinoma, but there are concerns about complete tumor excision with this procedure. The current review examines the data in regard to this issue as well as best practices to improve the success of partial nephrectomy.
Journal Article, May 2008
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CME
Molecular MRI of Hematopoietic Stem-progenitor Cells: In Vivo Monitoring of Gene Therapy and Atherosclerosis
Molecular MRI allows use of labeled hematopoietic stem-progenitor cells to identify diffuse atherosclerosis. New techniques in molecular MRI of atherosclerosis and their potential applications in clinical practice are reviewed.
Journal Article, May 2008
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Traumatic Biliary Stricture
A 48-year-old man with a history of short-gut syndrome presented with painless jaundice. Approximately 1 year earlier he was involved in a motor vehicle accident.
Clinical Case, May 2008
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Icyou: How Social Media Is the New Resource for Online Health Information
Prerna Mona Khanna, MD, MPH, Medical Editor, Icyou.com, Charleston, South Carolina, describes another promising use of the health Internet.
Expert Viewpoint, May 2008
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Perspective: Carotid Stenting and the History of Disruptive Technology in Vascular Surgery
Can CAS be considered a disruptive technology? An expert commentary from Frank J. Veith, MD.
Expert Viewpoint, May 2008
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CME
A 33-year-old Woman with Sudden-Onset Severe Headache and Vomiting
A 33-year-old woman presents to the ED with a severe headache, associated vomiting, blurred vision, and weakness in her left leg. She states that it is the worst headache of her life, and it is worsening despite her use of acetaminophen. She has a 4-year history of oral contraceptive use. Her pupils show a slightly sluggish reaction to light, and bilateral papilledema is noted on the funduscopic examination. A magnetic resonance venogram (MRV) is taken. What is the diagnosis?
Clinical Case, May 2008
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How to Treat Skin Infections, Including MRSA, in 2008
Erik Schraga, MD, with Stanford-Kaiser Santa Clara Emergency Medicine in California, explains the correct way to treat skin abscesses in 2008.
Editorial, May 2008
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Are Topical Patches Safe During MRI or CT Scans?
Staff members at diagnostic clinics often remove patients' topical patches before they undergo an MRI or CT scan. Is this necessary?
Expert Viewpoint, May 2008
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Last Call for Performance Enhancers: Richard Pound on Major League Baseball, the Olympics, and Gene Doping
The Major League Baseball Players Association was outrageous in its refusal to cooperate in the course of the Mitchell investigation.
Expert Viewpoint, May 2008
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Patients: An Untapped Safety Resource
Julia A. Hallisy, DDS, a dentist in San Francisco, California, teaches how patients can protect themselves.
Editorial, May 2008
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Cardiac Resynchronization Therapy in Patients With Mild Heart Failure: 12-Month Results of the REVERSE Trial
ACC.08: Is it time to expand indications for cardiac resynchronization therapy to include patients with less severe HF? REVERSE results support the need for further study in this patient population.
Journal Article, April 2008
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Underutilization of Thromboprophylaxis in Patients With Heart Failure
Gregory Piazza, MD, Clinical Fellow in Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Center, Boston, MA, discusses how poorly many hospitals are preventing deep vein thrombosis.
Expert Viewpoint, April 2008
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CME
A Young Woman with General Malaise and a Persistent Fever
A 21-year-old woman presents to the ED with a history of fever, general malaise, mild diffuse cramping and abdominal pain, and a cough with occasional blood-tinged sputum. She was recently diagnosed with HIV/AIDS, but she is not currently on antiretroviral medications. The patient appears cachectic and fatigued, and she is noted to be tachycardic, febrile, and has mild tachypnea. Diagnostic laboratory studies are conducted, and a chest radiograph and CT scan are taken. What is the diagnosis?
Clinical Case, April 2008
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CME
Inflammatory Breast Cancer: Treatment Over Time
Dr. Massimo Cristofanilli guides us through the challenging diagnosis and management of inflammatory breast cancer.
Clinical Case, April 2008
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Combination Chemotherapy May Be A Reasonable Alternative to Pelvic Radiation in High-Risk Endometrial Cancer
Dr. Maurie Markman describes the somewhat controversial work of investigators who explored the relative role of chemotherapy vs. pelvic radiation in intermediate- or high-risk endometrial cancer.
Expert Viewpoint, April 2008
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Announcing the Otolaryngology-Head and Neck Surgery Section of The Medscape Journal of Medicine
David Goldenberg, MD, Division of Otolaryngology-Head and Neck Surgery, The Pennsylvania State University, The Milton S. Hershey Medical Center, announces this new section of The Medscape Journal.
Editorial, April 2008
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Adjuvant Chemotherapy and Radiation Therapy for Breast Cancer: What Is the Optimal Sequence?
Does the sequence of adjuvant chemotherapy and RT affect outcomes for breast cancer patients? Dr. Thomas Buchholz summarizes the findings of several studies that may shed light on this question.
Expert Viewpoint, April 2008
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"Jake Leg," Other Poisonings, Physicians as Canaries, and the FDA
Emily Friedman, an independent health policy and ethics analyst, reminds us why doctors must be "canaries" and the FDA must act.
Editorial, April 2008
