PhotoclinicThese grouped, white to flesh-colored papules on the plantar aspect of a 28-year-old woman’s heels appeared during weight bearing and disappeared in non–weight-bearing positions.The patient, a nurse whose work required standing for hours, noticed the lesions about a year earlier.
Parkinson Disease, sleep and depressionAlthough the diagnosis and treatment of Parkinson disease is tricky enough to warrant subspecialty consultation and follow-up, affected patients frequent primary care practice for a host of related problems. A recent "Top Paper" contains diagnostic and therapeutic "pearls" that can facilitate caregivers' roles in a debilitating disease with increasing prevalence.
Primary Care<p><img alt="" src="http://www.consultantlive.com/image/image_gallery?img_id=1545986&t=1269968853428" style="float:left" width="150" /></p> <p>One of the most important roles for primary care practitioners is the review and implementation of necessary immunizations across a broad spectrum of age. Although adherence to the recommended schedule is better in children than in older patients, immunizations are equally crucial for adults.<sup>1</sup></p> <p>Each year the Advisory Committee on Immunization Practices of the CDC revises its recommendations. Here I review the key changes for adult immunizations for 2010.<sup>2</sup></p>