What's the Take Home?A 67-year-old woman is seen in the office a week after a long hospital admission for a variety of diabetes-related complications. She has had diabetes for 30 years, and her management has progressed from dietary changes to a variety of oral antidiabetes agents to, in recent years, injected insulin regimens.
PhotoclinicA 50-year-old man presented to the emergency department with intermittent chest discomfort for 8 days that had been associated with dyspnea and palpitations.
PhotoclinicA 22-year-old man with no relevant medical history presented to the emergency department with worsening epigastric pain radiating to the rib cage and the subsequent development of fevers, chills, nausea, vomiting, joint pains, and body aches over the past 10 days despite taking acetaminophen.
Photo EssayThis article is part 13 of a 15-part series of Photo Essays describing and differentiating conditions affecting the nails. Parts 14 and 15 will be published in upcoming issues of Consultant. To access previously published articles in the series, visit the Consultant archive at www.Consultant360.com and click the “Journals” tab.
Diabetes Q&AAlthough insulin analogues show noninferiority to conventional insulins in regard to glycemic control and hemoglobin A1c reductions, they are significantly more expensive, and health care providers need to better understand how to transition some patients back to more affordable options.
PhotoclinicA 3-week-old girl was brought to the clinic with a 2-day history of a scalp swelling. There had been no noticeable change in the size of the swelling or its location since its discovery. The swelling did not seem to be bothering the newborn; she had been feeding, behaving, and sleeping normally.