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October 2009 22 10 Issue of JAAPA

Editorial

"This must be true—I read about it on the Internet"

When patients search for health information on the Web, is what they find reliable? Do they understand what they read? Do they even tell you ...

Letters

Is concomitant use of PPIs and clopidogrel safe?

Use of drug-eluting stents for patients with coronary heart disease

Nonpharmaceutical options for hot flashes

Is black cohosh a safe and effective substitute for hormone replacement therapy?

Clarification of the meaning of a negative test result

Should I be tested for the BRCA gene?

Cinacalcet may be used only for a select group of patients

QRS: Rotator cuff disease; Hyperparathyroidism

Dermatology Digest

Underarm rash worsens with OTC treatment

A patch of irritated skin on this patient's axilla developed into a pruritic rash that worsened with OTC treatment. Punch biopsy revealed the diagnosis.

A Day in the Life

A Day in the Life: Alexandra Godfrey, BSc, PT

A day in both the anatomy lab and the hospital teaches this student how a constant awareness of illness, suffering, and loss will be part ...

CME

Beyond the red reflex: Examining the eye with an ophthalmoscope

This versatile clinical tool has changed little since its humble beginnings. The use and care of the ophthalmoscope is reviewed.

Understanding the link between HPV and oropharyngeal cancers

As traditional risk factors decline, investigators are investigating other potential risk factors for head and neck cancers.

CME Posttests

CME Posttest: The ophthalmoscope; HPV and oropharyngeal cancers

October 2009

Case Reports

Referral to a dietitian uncovers why this woman cannot lose weight

This eating disorder is probably often missed in primary care because the condition is so difficult for providers to recognize.

Poor medication history plus slow symptom onset delays a diagnosis

The best way to identify this type of adverse drug reaction is to obtain and document a complete and accurate medication history.

Research Corner

What influences practice location and specialty?

The student selection process and curriculum are important in producing primary care physicians and physicians willing to serve in rural and underserved settings. Public and ...

The Surgical Patient

Endovascular embolization with a vascular plug corrects a PAVM

A pulmonary arteriovenous malformation, discovered as an incidental finding on a chest CT, is corrected with a vascular plug.

What's New

Benefits and harms of widespread PSA test use still unclear

Despite the publication of the preliminary results of two studies and the update of two sets of guidelines, the benefits of prostate cancer screening are ...

Sounding Board

How I learned to rate pain

This physician assistant learns a valuable lesson on how difficult it can be to describe pain when she becomes a patient with acute abdominal pain.

POEMs

Ultrasonography, followed by CT if negative, is best for acute abdomen

Clinical question: In patients with nontraumatic acute abdominal pain, what is the best strategy for detecting urgent conditions?

Treatment of AOM leads to subsequent ear infections

Clinical question: Does antibiotic treatment of acute otitis media (AOM) increase the risk of subsequent ear infections?

Immediate angioplasty after fibrinolysis is beneficial for patients with STEMI

Clinical question: Is early angioplasty following fibrinolysis more effective than delayed or rescue angioplasty in patients with ST-segment elevation myocardial infarction (STEMI)?

Metoclopramide safe during first trimester of pregnancy

Clinical question: Is metoclopromide safe in pregnancy?

Metoclopramide safe during first trimester of pregnancy

Clinical question: Is metoclopromide safe in pregnancy?

Hormones plus radiation has better outcomes than radiation alone

Clinical question: Does adding hormone suppression to radiation improve outcomes in men with locally advanced prostate cancer?

N-acetylcysteine effectively treats trichotillomania symptoms

Clinical question: Is N-acetylcysteine (Mucomyst) effective in the treatment of trichotillomania?

Diagnostic Imaging Review

A 17-year-old male with leg weakness and low back pain

These cysts, named for their radiographic appearance and common in younger patients, comprise approximately 1% of bone tumors.

Humane Medicine

A jaundiced view: More than meets the clinician's eye

The author reflects on just how much he has left to learn about how a disease can impact the lives of those who suffer from ...

Case of the Month

Persisting shin tenderness and erythema

This patient experienced shin pain after a long walk. The next day, an ankle sprain was diagnosed. The clue was in his medical history of ...

Ask a Librarian

Ask a Librarian!—October 2009

What's the best way to find good quality meta-analyses that answer your clinical questions? This month's installment answers that question.

Eliminating Health Disparities: What Works?

Eliminating health disparities: What works?—October 2009

This column examines recent literature on health disparities, emphasizing tools that can help clinicians to assess and address disparities in their own practices. This month's ...