Diagnosis & Disease Information

Separating anxiety from physical illness

Anxiety disorders are surprisingly common and often go undiagnosed.Their ability to mimic numerous medical conditions adds to the challenge. Anxiety disorders make up the most common category of psychiatric conditions, affecting about 17 million to 19 million American adults every year. One of the challenges in diagnosing the disorders is that most patients present with…

Evidence-based medicine on the Web

Tapping into the latest scientific findings is not just for the academic elite. All you need is access to the Internet. Here’s a review of four Web resources. The heart of evidence-based medicine is the application of the latest and best research to clinical practice. Thanks to online resources—including one that I developed—clinicians can conveniently…

Veregen – An ointment for genital and perianal warts

Company: Doak and Kenwood Pharmacologic class: Botanical Active ingredient: Sinecatechins 15%; ointment. Continue Reading Indication: External genital and perianal warts (Condylomata acuminata) in immunocompetent patients ≥18 years. Pharmacology: Veregen is a topical ointment that delivers sinecatechins, a partially purified fraction of the water extract of green tea leaves from Camellia sinensis (L.) O. Kuntze. Sinecatechins…

Bystolic- Another beta blocker for hypertension

Company: Forest Pharmacologic class: Cardioselective beta-blocker Active ingredient: Nebivolol (as HCl) 2.5 mg, 5 mg, 10 mg; tabs. Continue Reading Indication: Hypertension, alone or with other antihypertensives. Pharmacology: Nebivolol is a once-daily beta-adrenergic blocking agent that, at doses up to 10 mg, is primarily beta1-selective. In poor metabolizers (those with reduced activity of CYP2D6) and…

Two shiny, flat eruptions

CASE #1 An 18-year-old female complained of a rash around her umbilicus for the past several months. Recently she had developed a papular eruption on her body. Both eruptions were pruritic. During history-taking, she noted that her daily attire consisted of jeans with metal clasps and a belt with a large metal buckle. She had…

Whose standard of care applies?

A lawyer challenges the legitimacy of an expert’s opinion after an NP misses an incipient stroke. Mr. L, 37, was a nurse practitioner in the busy emergency department of a large hospital. He was on duty when a 56-year-old woman came in complaining of a headache that had lasted for two weeks, along with nausea…

Too much empathy can backfire

When a clinician identifies with a patient’s condition, objectivity may be lostand mistakes become likely. Dr. F, 58, was planning to retire in a few years and go to work for an international medical charity. Because she had never been sued, she believed she was at low risk for facing a malpractice claim at this…

Nodular fasciitis

Dr. Kirkby is a family medicine physician with a private practice located in Pietermaritzburg, KwaZulu-Natal, South Africa, and an editor for DynaMed (www.ebscohost.com/dynamed), a database of comprehensive updated summaries covering nearly 3,000 clinical topics. Dr. Fiesinger is a faculty member of the Conroe Medical Education Foundation Family Medicine Residency Program, Lone Star Family Health Center,…

Let’s start admitting our mistakes

The responsibility to act with civility applies to all of us, all the time, whether physician, nurse practitioner, physician assistant, or transport assistant. Apology and truth-telling — basically, acting civil — should be a requirement of everyone in the health-care industry. Developing your apology begins with paying attention to those situations of the least infraction…

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