Case In PointA 31 year-old man presented to the internal medicine clinic after extensive workup for infertility, to include evaluation by endocrinology and urology resulting in the diagnosis of azoospermia by 2 separate semen analyses.
Case in Point PediatricsA 6-month-old African American girl first presented to the dermatology clinic at Children’s Medical Center of Dallas for large birthmarks.
Conference SpotlightA 31-year-old mother of two presented after several months of runny diarrhea.
Conference SpotlightGout, characterized by recurrent attacks of acute inflammatory arthritis and an appearance of red, swollen, tender joints, was the topic for discussion as Benroe Blount, MD, MPH, MAAFP, addressed the full session.
PhotoclinicA 66-year-old female’s left ear shows a nodule with shallow pink ulcerated top at the superior aspect of the antihelix.
DermclinicThis otherwise healthy 36-year-old female presented with a 1 month history of an itchy rash confined to both lower extremities.
Nutrition. Linda M. Delahanty, MS, RD, LDN, spoke about how nutrition is a crucial piece of the puzzle in reducing cardiometabolic risk.
HypertensionResistant hypertension is a common clinical condition.
heart diseaseCardiovascular disease is the number 1 killer among women, and is more deadly than all forms of cancer combined.
Diabetes Q&AThe 2013 Primary Care Cardiometabolic Risk Summit kicked off with a keynote address from John E. Anderson, MD.
Diabetes Q&ABeta-cell function declines over the course of type 2 diabetes and patients may eventually require insulin therapy to achieve or maintain glycemic control.
StatinsStriking a balance between the benefits and adverse effects of treatment is often challenging, particularly as it relates to statin therapy.
prediabetesUp to 70% of individuals with prediabetes will eventually develop diabetes, according to an American Diabetes Association expert panel.
Diabetes Q&AThere are now 12 classes of antihyperglycemic medications for clinicians to consider when developing a treatment plan for diabetes patients.
LipidsPeter H. Jones, MD, FACP, FNLA, discusses how to implement guidelines that provide risk stratification algorithms to maximize cardiovascular protection.
amyloidosisMeredith Hancock, BA, Rashid Rashid, MD, PhD, and Amor Khachemoune, MD
PhotoclinicA 56-year old woman presented with an asymptomatic rash on her face that began around the time she started using Colgate PreviDENT 5000 Enamel Protect, a high fluoride toothpaste prescribed by her dentist for dental caries.
nodularisA 58-year-old female’s right ear shows a 0.5 cm diameter skin-colored nodular lesion with a central dry white top on the antitragus. She had noticed the lesion 1 month prior. It was asymptomatic.
Chest X-raysA 32-year-old woman presents for evaluation of an incidentally found abnormal CXR.
PsoriasisThis 62-year-old female has been on etanercept (Enbrel) for over 1 year for treatment of psoriasis and presents with a tender eruption of three days duration on her right arm.
celiac diseaseThis otherwise healthy 62-year-old male presented for evaluation of his second episode of painful purplish swelling of his toes in the wintertime.
cystA male in his twenties presented to his physician's office complaining of a sore throat for 7 days with a slightly worsening cough.
Herpes zosterHerpes zoster1, otherwise known as shingles, is a viral disease characterized by a painful skin rash. Selecting this medical condition as the topic of this Top Paper should come as no surprise. Incidence of herpes zoster is on the rise and as primary care physicians, we are on the receiving end of an increased marketing push for the agents used to treat our patients. This paper offers advice for clinicians.
Diabetes Q&AAlthough hemoglobin A1c is usually the best test to estimate the average glycemic control in patients with diabetes, it is unreliable in some clinical circumstances. In select patient populations, measuring fructosamine and glycated albumin levels may also be useful.
Hematology, OncologyThe American College of Physicians presents subspecialty updates highlighting publications from the preceding year in the Annals of Internal Medicine that impact the practice of medicine. These are invaluable resources for all primary care practitioners, and in essence, are a quick hematology/oncology and infectious disease consultation.
Nail diseaseA 54-year-old Caucasian man presents with more than a 9 month history of a dark band on the right fifth finger. The patient denies any history of trauma and reports that the dark band has not increased in size or become darker. On exam, no dark band was observed on other digits.
CommentaryAn excellent read on the life of Sir William Osler can be found in Charles S Bryan’s Osler: Inspirations from a Great Physician.1 Here are some important take-home messages:
Editor’s NoteI recently attended the American Academy of Family Physicians Scientific Conference in San Diego (September 24-28, 2013) and days after I left, I was still thinking about the tagline: Real Issues, Real Answers, Real Voices. The motivation behind the motto was to help physicians remember all the reasons behind their choice to enter the field of family care.