You see a 29-year-old female insurance saleswoman with a 6-week history of joint pains and swelling affecting both hands and wrists, both feet and her left knee. Her symptoms are worse when she first gets up in the morning and it takes a few hours before her joints seem to loosen up.
For some patients the first treatment they receive to help manage their pain is opioid medication. Recent studies have looked at whether staying on these prescriptions for long periods of time can do more harm than good.
A 28-year old man comes in who recently arrived in southern California from South America and suddenly developed a "cold." His symptoms included productive cough, shortness of breath, chest pain, fever, weakness and malaise. He also reported unexplained weight loss. Sputum and blood specimens were obtained for acid-fast smear examination and culture. A single posterior-anterior chest radiograph was obtained as part of his initial evaluation.
This 29-year-old man came in for a wellness evaluation but notes having had this rash for 8 years. Occasionally it itches, but otherwise is asymptomatic and he has had no treatment for it to date. He does not take any medications and has no significant past medical history.
Dietary sodium restriction is frequently recommended as a means to manage hypertension, congestive heart failure and cardiovascular disease. However, with the growing focus on patient-centered outcomes rather than disease-centered outcomes, the importance of sodium restriction becomes less clear.
Although the obesity epidemic in the United States seems to have reached a plateau over the past few years, the prevalence of obesity continues to be high with 30% of Americans classified as obese, defined as having a BMI of 30 kg/m2 or more, and an additional 30% overweight, with a BMI of 25 to 29.9 kg/m2.