For many physicians, working during the holiday season is simply part of the job.
Once revered and idolized by society and patients, physicians are increasingly being subjected to verbal and physical violence at work.
The American College of Rheumatology and the National Psoriasis Foundation have released 2018 joint recommendations for the treatment of psoriatic arthritis.
In publishing updated appropriate use criteria, the organizations hope to provide guidance to clinicians who may refer patients for revascularization therapy.
In Case 1, a 24-year-old man presents to his primary care physician with complaints of new-onset sore throat and fatigue. In Case 2, a 50-year-old man presents to an urgent care clinic complaining of a fast-developing pruritic rash after being stung by a wasp.
The European Medicine Agency has reported that there may be an association between long-term lithium use and reports of both renal tumors and thyroid cancer.
A court must choose whether to accept a hospital's explanation that a nurse was fired for violating HIPAA or let a jury decide whether the hospital's action was merely a pretext for firing the nurse for taking advantage of FMLA.
Clinicians are gaining a better understanding of how asthma and allergies are regulated by the circadian clock, which will help patients better alleviate their symptoms.
Low vitamin D levels have been linked to multiple diseases including some cancers, neurologic disorders, decrease in bone density, and cognitive decline in the elderly, and research suggests that a possible inflammatory response in the gut when vitamin D levels are low may cause irritable bowel syndrome.
A previously healthy 4-month-old infant presents with weak cry, inability to feed, and having the appearance of a "floppy rag doll."
A 30-year-old woman who is 6 weeks pregnant calls into the after-hours Ob/Gyn line over the weekend with reported spotting.
As infection may also lead to worsening symptoms in patients with myasthenia gravis, clinicians must balance prompt and adequate treatment of infection with the risk that some antibiotics can aggravate the condition.
Many components of diet have been implicated as possible risk factors for RA, with varying degrees of evidence.
The concept of thirdhand smoke was originally introduced in 1953, when rodent studies first demonstrated the carcinogenic effects of the residue from tobacco smoke.
Type 1 diabetes predisposes children and adults to autoimmune diseases, which can impair glucose metabolism and interfere with insulin therapy.
Bronchoscopic lung volume reduction with valve replacement shows the most promise for improving lung function, exercise tolerance, and quality of life in patients with advanced emphysema.
Recent research points to an association between the gut microbiome composition and various types of immune-mediated inflammatory arthritides.
Mean changes in hematologic indices found similar regardless of same-day or prior administration of B12 supplementation in patients receiving pemetrexed for NSCLC or pleural mesothelioma.
A 53-year-old obese man with a history of diabetes and hypertension presents with migratory bilateral ankle pain that is worse on the left side.
With obesity reaching epidemic proportions, and its known association with many metabolic disorders such as type 2 diabetes, dyslipidemia, hypertension, and atherosclerosis, it is worthwhile to look at nutritional approaches to managing these chronic conditions.
The results highlight the importance of evaluating and monitoring cognitive function in individuals with recent critical illness or major infections, especially if they are already at risk for dementia.
In Case 1, 55-year-old man presents to the clinic with multiple tense bullae diffusely involving his trunk and extremities that overlie urticarial plaques. In Case 2, 40-year-old African American man presented to the clinic with a few small flaccid blisters as well as multiple crusted erosions and some areas of post-inflammatory hyperpigmentation on his back and in the creases of his elbows.
The new guidelines will facilitate the design and development of clinical trials to test new therapies to minimize the burden of neurologic disability produced by neurosarcoidosis.
A recently discharge patient dies in a tragic fire, and the hospital and treating clinicians are subsequently named in a lawsuit.
There is a lack of consensus among experts and professional organizations whether HCV screening in pregnant women should be risk based or universal.
A 25-year-old man complaining of chest pain and with evidence of significant chest trauma presented to the emergency department after suffering an accident while riding an all-terrain vehicle.
As new research indicates that long-term use of artificial sweeteners may increase body mass index, a literature search was performed to assess the effect of artificially sweetened beverages on weight gain in the pediatric population.
Multiple system atrophy is a rare, progressive neurodegenerative condition for which there is currently no cure.
Researchers examined evidence suggesting that probiotics may exert antidepressant effects via anti-inflammatory mechanisms.
A 44-year-old man presents to the hospital with generalized abdominal pain, malaise, subjective low-grade fever, and a bruise on his left shin. He has an extensive medical history including HIV, hypertension, diabetes, and GERD, but he denies vomiting or diarrhea.
The efficacy of nonpharmacologic agents for wound care should encourage discussion of their usefulness and appropriateness in wound management.
A patient presents with asymptomatic hyperpigmented plaques on the neck and upper trunk that have persisted for several weeks despite rigorous scrubbing with soap and water.
Recent high-quality clinical trial evidence has demonstrated that medications commonly prescribed for migraine prevention in pediatric patients were not superior to placebo for reducing headache symptoms.
Use of a fax machine and lack of a timely response resulted in the demise of a patient and an accusation of gross negligence.
A recent systematic review found that nurse-led care is effective, acceptable, and safe in patients with rheumatoid arthritis.
Community paramedics are trained within the standard paramedic education model and then complete program-dependent training with a goal of decreasing unnecessary hospital readmissions and improving overall patient care.
Many cases of vaginal foreign body are unusual and often difficult to detect.
As healthy levels of folic acid, iodine, magnesium, vitamin D, and iron demonstrate improved outcomes in pregnancy, understanding of the function of these essential nutrients on health would benefit family practitioners caring for women of childbearing age.
A 32-year-old woman presents to the emergency department with gradually worsening generalized headache 8 days after giving birth to her second child.
South Asians exhibit the highest rates of ASCVD among all ethnic groups, and the highest prevalence is in younger age groups; up to 25% of myocardial infarctions in India occur in individuals younger than 40 years of age.
Despite their advantages, many clinicians do not necessarily agree with the centrality or content of CPGs. Others — especially primary care physicians (PCPs) — are overwhelmed by the vast and ever-increasing numbers of guidelines issued by multiple societies.
A nurse practitioner working in the safe child center of the outpatient pediatric wing of a regional hospital is called to testify in an abuse case.
An estimated 31 million Americans will experience low back pain at some point in their lifetime.
Although the American Academy of Dermatology recommends the direct application of emollients to the skin in patients with atopic dermatitis, the addition of oils, emollients, or other additives to bath water is not recommended due to insufficient evidence regarding their efficacy.
Although endocrine therapy following surgery is recommended for HR-positive/HER2-negative, axillary node-negative breast cancers, the value of adjuvant chemotherapy in the setting of moderate risk is unclear.
Although exclusive breastfeeding for the first 6 months of life is recommended by several health organizations, there may be a delay before abundant maternal milk production is established.
The SYGMA trials assessed the use of an as-needed combined corticosteroid/beta-agonist inhaler in patients with mild asthma.
An elderly man presents to the emergency department with elbow and biceps pain after falling on the stairs.
Raising Awareness of Pseudobulbar Affect: Knowing the Signs, Symptoms, and Treatment for Patients With Uncontrollable Laughing or Crying
Pseudobulbar affect is a significant national health issue in the United States, with approximately 2 million individuals affected.
The early diagnosis and management of prediabetes will have a significant impact on patient outcomes and healthcare spending.
A HIPAA violation harms the successful career of a healthcare provider and causes problems for her former and current employers.
The demand for PAs, along with the escalating number of PA applicants, has helped fuel the growth.
Cleft lip and palate is defined as congenital malformation of the upper lip and/or oral cavity disrupting normal facial structure and oromotor function.
An elderly woman with a history of hypertension and metastatic bladder cancer presents to the ED with bilateral finger pain and cyanosis associated with a 15-lb weight loss.
Changes in the NP profession over the past 20 years include the growth of the profession, methods of practice, and the types of patients and conditions treated.
A clinician quits her job but afterward sues for wrongful termination.
Divergent recommendations in guidelines from the USPSTF and the ATA/AACE contribute to the controversy surrounding whether to test and treat for subclinical hypothyroidism.
The United States has the seventh highest prevalence of Chagas infection in the Western hemisphere, with most cases seen among immigrants from Latin America.
DBS has been known to generate other movement-related disorders such as dyskinesias, blepharospasm, and hypokinesia.
Discussions involving Internet challenges with children and adolescents should be as sensitive as those about sexuality and drug or alcohol use.
Chronic low back pain (LBP) defined as persistent or fluctuating musculoskeletal pain of lower back and lumbar spine lasting >3 months.
Current oral contraceptive products contain lower doses of estrogen than those used in the past, prompting reconsideration of risks and benefits.
With the advent of platform manufacturing technology, vaccines can be developed quickly to stop the spread of outbreaks.
Poor control of asthma and obstructive sleep apnea can feed off one another, according to Michelle Zeidler, MD, pulmonologist at the University of California, Los Angeles, and director of the UCLA Sleep Fellowship Program.
Although all of the guidelines acknowledge that there are emergent situations in which providing care for a family member or friend is not only permissible but also essential, other situations are frowned upon.
A clinician fails to follow up after ordering diagnostic tests for a patient.
A 90-year-old woman with a history of coronary disease and gallstones presents to the emergency department with generalized abdominal pain that started suddenly about 7 hours prior.
To shed further light on the study's implications, MPR interviewed lead author Anupam B. Jena, MD, PhD, Ruth L. Newhouse Associate Professor, Harvard Medical School, Boston, MA.
Primary care providers should screen for depression and other health-related risks associated with the use of social media by adolescents.
In 2003, the Human Genome Project became the culmination of the history of genetics research, allowing us to understand the role of genetics in human health and disease. As part of The Clinical Advisor's 20th Anniversary, this article explores the influence of race and genetics in clinical practice.
Migraine is highly prevalent in children and adolescents, affecting almost 10% of children between 5 and 15 years old and 30% of adolescents between 15 and 19 years old.
A patient dies after a clinician fails to act on signs of a potential case of deep vein thrombosis.
Patients with ALS require multidisciplinary care and rehabilitative interventions; maximizing independent function and quality of life are the goals.
A 55-year-old man with chronic obstructive pulmonary disease reports having some mild chest pain.
Some include mechanical complications, central vascular access complications, and compatibility issues.
Advances in new reversal agents will be key for managing patients treated with DOACs to prevent major bleeding events.
Medical records of 48 children examined by Asperger show that he specifically called for 12 of the children to be transferred to the Am Spiegelgrund facility, the 'euthanasia' institution founded in 1940.
Testosterone therapy is recommended in men with hypogonadism to correct symptoms of testosterone deficiency. Men who are otherwise healthy do not need to be screened for hypogonadism.
A 44-year-old woman presents to her local emergency department after 5 days of persistent fever, productive cough, and worsening dyspnea on exertion.
A clinician attempts to void a restrictive noncompete clause that she had signed before beginning her current job as an NP.
A 68-year-old patient with type 2 diabetes presents to a urologist to evaluate funguria, and a CT scan showed right hydroureteronephrosis.
Deep vein thrombosis is a significant source of morbidity and mortality, so it is imperative that clinicians understand how to recognize and treat patients with the disorder.
A 25-year-old woman presents to the emergency department with a chief complaint of headache, back pain, and fever, while also experiencing some vaginal itching and discharge.
Described as death within an hour of onset of any symptom
A 32-year-old woman, diagnosed several months earlier with pulmonary arterial hypertension, presented to the emergency department with dyspnea and near syncopal episodes.
A clinician shares a patient's incorrect diagnosis with another government agency.
A 64-year-old woman who was recently diagnosed with colorectal cancer is brought to the emergency department with substernal chest pain and shortness of breath.
The first step for managing a patient with diarrhea is to determine the severity of dehydration according to the estimated volume loss and the symptoms and signs noted on physical examination.
Intimate partner violence was reported in over 30% of female psychiatric patients.
A 52-year-old man presents to the emergency department with dizziness and fatigue after a syncopal episode on a camping trip.
Intravenous, patch lidocaine might be effective in treating, preventing chronic pain.
A 33-year-old man presents to the emergency department for 6 small spots on his chest, arms, and legs that gradually grew in diameter after using a topical cream and cephalexin.
Dr Windel Stracener, a family practitioner for 22 years, discusses substance abuse, sexual activity, and other sensitive topics many clinicians do not ask their patients.
A nurse in a VA facility files a complaint against a clinician, which ends with a criminal conviction.
Primary prevention efforts such as exercise, weight control, cessation of smoking, and alcohol intake can greatly affect the development of CAD.
UTIs present clinically as dysuria, with symptoms of frequent and urgent urination secondary to irritation of the urethral and bladder mucosa.
A 42-year-old man presents to the emergency department with vertigo that is worse with head motion as well as vomiting, but has no headache or abdominal pain.
NIH's National Institute of Allergy and Infectious Diseases is researching ways to develop a universal influenza vaccine against multiple strains.
In 1918, between 50 and 100 million people are thought to have died from the great influenza pandemic, representing as much as 5% of the world's population.
A 55-year-old obese woman with hypertension, diabetes, and scleroderma is referred for follow-up after a recent admission for new-onset heart failure.