The posts below are excerpted from the NEJM Resident e-Bulletin, a free weekly email of teaching topics. Including the content here in Now@NEJM enables you to have a conversation or ask questions about clinical points that interest you. To receive the email version, register as a student or resident on NEJM.org.
Posts in the ‘Physicians-In-Training’ Category
Fever and Rash
Posted by Sara Fazio • May 10th, 2012
In the latest Case Record of the Massachusetts General Hospital, a 43-year-old woman with a history of atopic dermatitis was admitted to the hospital because of fever and a generalized painful, pruritic rash involving the entire body. Examination revealed vesicles, pustules, and erosions with scalloped borders. A diagnostic test result was received. The development of cutaneous pain… Read More…
Percutaneous Coronary Interventions (PCI)
Posted by Sara Fazio • May 10th, 2012
PCIs for acute coronary disease are increasingly being performed at centers without on-site surgical backup. This review summarizes the safety and the efficacy of this practice, along with the policy implications, including those for patients undergoing elective procedures. Certification to perform catheter-based interventions for coronary artery disease was originally limited to hospitals that had the capability to… Read More…
Thyroid Cancer
Posted by Sara Fazio • May 4th, 2012
A new trial compared two thyrotropin-stimulation methods and two 131I doses for postoperative ablation in patients with low-risk thyroid cancer. Rates of ablation were similar in all treatment groups. Doses lower than those currently recommended may be adequate for this condition. In patients with low-risk thyroid cancer, it is unclear whether the administration of radioiodine provides… Read More…
Whistling in the Dark
Posted by Sara Fazio • May 4th, 2012
In a new Clinical Problem-Solving article, shortness of breath, fever, and cough productive of yellow sputum developed in a 38-year-old woman soon after the birth of her third child. Although her symptoms initially resolved with antibiotics, an intermittent nonproductive cough, wheezing, and shortness of breath soon followed. It is important to consider a broad differential… Read More…
Paresthesias and Anemia
Posted by Sara Fazio • April 25th, 2012
In the latest Case Record of the Massachusetts General Hospital, a 62-year-old man was admitted to this hospital because of paresthesias, weight loss, jaundice, and anemia. Diagnostic test results were received. Paresthesias involve a sensation of tingling, numbness, crawling, or deadness, and they are felt mainly in distal parts of the extremities. Although they very rarely involve… Read More…
Alopecia Areata
Posted by Sara Fazio • April 20th, 2012
The impact of certain skin diseases on the lives of those affected tends to be underestimated or even dismissed as simply a “cosmetic problem.” Alopecia areata exemplifies such a condition, owing to its substantial disease burden and its often devastating effects on the patient’s quality of life and self-esteem. The latest review article from our… Read More…
Vomiting and Unresponsiveness
Posted by Sara Fazio • April 20th, 2012
In the latest Case Record of the Massachusetts General Hospital, a 10-month-old girl was seen in the emergency department because of vomiting and episodes of unresponsiveness, which had begun suddenly 7 hours earlier. She gradually became somnolent. Vital signs, a physical examination, and brain imaging were normal. The immediate approach to a child who presents… Read More…
A Man with Weakness and Rash
Posted by Sara Fazio • April 13th, 2012
In the latest Case Record of the Massachusetts General Hospital, a 60-year-old man from coastal New England was admitted to this hospital because of fever, weakness, rash, and renal failure. An initial measurement of creatine kinase was 20,437 U per liter. A diagnostic test was performed. The differential diagnosis of a maculopapular rash with an… Read More…
Dengue
Posted by Sara Fazio • April 13th, 2012
There are an estimated 50 million infections per year with the dengue virus, which is transmitted primarily by urban adapted Aedes aegypti mosquitoes. The latest review in our Current Concepts series summarizes pathophysiology and treatment as well as prospects for a vaccine and for vector-control approaches. Dengue is a self-limited, systemic viral infection transmitted between humans… Read More…
