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Managing UTIs in debilitated patients

A common occurrence among this patient population, urinary tract infection causes significant morbidity and mortality.

Correcting common nutritional deficiencies

The typical American diet may not provide all the nutrients needed for good health. You can help patients eat their way to a better life.

An elderly woman with GI bleeding, ataxia, and an unexpected twist

Symptoms of fatigue and history of breast cancer raise clinicians’ concerns over development of a new primary cancer. Ms. Q, a 70-year-old retired clinician, presented with a six-month history of weight loss (30 lb), falling down, fatigue, anorexia, low-grade fevers, and bloody stools. Her medical history was significant for mitral valve prolapse; infective endocarditis (IE)…

Abnormal growths on the hand and wrist

Most cysts, tumors, and other lesions can be diagnosed and even treated in your office. A trio of experts provides step-by-step guidance. This is the second of a two-part series. Part 1 appeared in the March issue. Primary-care clinicians are frequently the first medical professionals to examine patients with bumps and abnormal wounds around the…

Baldness drug throws off PSA

As little as 1 mg/day of finasteride can seriously distort results of prostate-specific antigen (PSA) testing, a study shows. That’s the dosage of Propecia used by more than 4 million men to treat male-pattern baldness, and shown by the study to lower serum PSA concentrations by as much as half. Finasteride is also sold as…
Legal Advisor

Delaying a visit proves deadly

The patient, who had rectal bleeding, wasn’t seen by a specialist for four months. But whose fault was that? Mr. H was an experienced physician assistant in a family-practice clinic. He was mainly responsible for routine follow-ups with adults who had chronic diseases, such as diabetes and hypertension. One day, a 65-year-old man with both…
Advisor Forum


The patient whose prostate-specific antigen (PSA) level went from 6.1 ng/mL to 4.76 after two weeks of antibiotic therapy (Item 98-11) now has a PSA of 2.89, despite the fact that he received no additional antibiotics. (The absence of cancer was confirmed by a negative biopsy; prostatitis was postulated but never formally diagnosed.) He takes…
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