Table of Contents
From the Editor
- Pericarditis as a window into the mind of the internist
In looking for an underlying cause, we need to be thorough but also contain costs and avoid harm from overtesting.
The Clinical Picture
- A lump in the umbilicus
An estimated 1% to 3% of patients with cancer in the abdomen or pelvis present with a nodule in the umbilicus.
- Light-headedness and bradycardia in a 72-year-old woman
Complete heart block is a form of atrioventricular (AV) dissociation, but not all AV dissociation is complete heart block.
- Morphea-like plaques, induration of the extremities, and eosinophilia
Eosinophilic fasciitis is suspected in a patient with eosinophilia and characteristic cutaneous features.
Point and Counterpoint
- Annual mammography starting at age 40: More talk, less action?
In view of the potential harm, we question annual screening starting at age 40.
- Screening mammography starting at age 40: Still relevant
In women in their 40s, the incidence of breast cancer is low but the risk of a tumor being aggressive is especially high.
1-Minute Consult
- When does pericarditis merit a workup for autoimmune or inflammatory disease?
Further evaluation is required for recurrent pericarditis resistant to conventional therapy or for manifestations of systemic disease.
Im Board Review
- A 79-year-old with acute portal vein thrombosis
The patient, who had a history of polymyalgia rheumatica treated with corticosteroids, presented with chills and fever.
Review
- Penicillin allergy: A practical guide for clinicians
Clinical presentation is key in classifying reactions as either mediated by immunoglobulin E or not.
- Stand by me! Reducing the risk of injurious falls in older adults
Practitioners can reduce falls by yearly screening and evidence-based interventions.
Medical Grand Rounds
Dermatology update: The dawn of targeted treatmentNew, targeted therapies are changing the way advanced basal cell carcinoma, psoriasis, and metastatic melanoma are treated.
Departments
- Clinical utility of warfarin pharmacogenomics (August 2013)
Readers comment on warfarin pharmacogenomics (August 2013).
