Table of Contents
From the Editor
- Zoster is more than ‘just’ a viral infection
For some viruses, such as varicella-zoster virus, striking and confusing clinical manifestations can appear long after the initial infection.
Review
- The painful shoulder: When to inject and when to refer
Many physicians find shoulder pain difficult to sort out and treat. However, most cases can be diagnosed in a 5-minute history and physical examination and treated with a combination of physical therapy, injections, and time.
- The protean neurologic manifestations of varicella-zoster virus infection
Varicella-zoster virus reactivation can produce a number of neurologic complications, including herpes zoster (shingles), postherpetic neuralgia, vasculopathy, myelitis, neurologic disease without rash, and necrotizing retinitis.
Medical Grand Rounds
- Cardiovascular medicine update 2007: Perioperative risk, carotid angioplasty, drug-eluting stents, stronger statins
Should patients with coronary artery disease who need noncardiac surgery undergo angioplasty first to lessen their perioperative risk? Is percutaneous carotid angioplasty an acceptable alternative to open surgery? Are drug-eluting stents safe in the long term? What is the best regimen and goal for managing lipid levels in patients with coronary artery disease?
The Clinical Picture
- Bilateral parotitis and facial nerve palsy
The patient also has anterior uveitis and a small skin lesion. Which underlying condition is most likely?
Current Drug Therapy
- Buprenorphine maintenance: A new treatment for opioid dependence
New regulations allow physicians who are certified in buprenorphine therapy to offer it in their offices, substantially increasing patient access to treatment for opioid dependence.
Cardiovascular Board Review
- A young woman with severe hypoxemia, electrocardiographic changes, and altered mental status
This case highlights the importance of thorough history-taking and the need to maintain a broad differential diagnosis, even if the test results seem definitive.
Imaging in Practice
- A small pulmonary nodule, found incidentally
Most very small nodules are benign, but once identified, they need to be followed.