Table of Contents
From the Editor
- Celiac disease in the ‘nonclassic’ patient
Adherence to a strict gluten-free diet is not easy, and even strict adherence does not guarantee relief of all symptoms. We need to be as certain as possible that trying the diet makes sense—and that is the real challenge.
The Clinical Picture
- Eruption of erythema after dieting
During the past 4 weeks, the patient had been increasing his exercise and was on a strict diet for bodybuilding
- Finger nodules: Tip of the gouty iceberg
Recurrent, dramatic flares are the cardinal symptom of gouty disease, but some patients exhibit tophi on physical examination or imaging—without flares or pain.
Smart Testing
- Serial serum lipase testing after the initial diagnostic workup for inpatients with acute pancreatitis: What is the evidence?
Beyond the initial diagnostic workup, the results of serial testing may be misleading, with the potential for adverse effects on patient care and increases in healthcare spending.
1-Minute Consult
- Should urine antigen testing for Legionella pneumophila be ordered for all hospitalized patients with community-acquired pneumonia?
Testing is recommended if the pneumonia is severe, if there has been recent travel, and if there is currently an outbreak of legionnaires disease.
- Celiac disease: Who should I test, and how?
First-degree relatives of patients with celiac disease and patients with dermatitis herpetiformis, type 1 diabetes mellitus, and autoimmune thyroid disease are among those for whom testing is advisable.
Guidelines to Practice
- Guidelines for the management of trigeminal neuralgia
Care pathways for patients with trigeminal neuralgia vary widely. The most recent UK guidelines emphasize the need for evidence-based care plans for multidisciplinary management.
Review
Measuring exhaled nitric oxide when diagnosing and managing asthmaThe authors examine the role of this biomarker of airway inflammation and provide guidance for its appropriate use.
- Deadly drug rashes: Early recognition and multidisciplinary care
An illustrated review of 4 severe drug rashes. Early recognition and prompt withdrawal of the causative agent are crucial.
