The definition of hypertension was recently changed by the American College of Cardiology – American Heart Association to a systolic arterial pressure of more than 130 mm Hg, a diastolic pressure of more than 80 mm Hg, or both. Continue reading “New Diagnostic and Treatment Criteria for Hypertension in Adults”
Acne is a primary inflammatory disorder involving the pilosebaceous unit. The pathogenesis is multifactorial, involving four key factors with interrelated mechanisms: increased sebum production, hyperkeratinization of the follicular infundibulum, inflammation, and Cutibacterium acnes (formerly Propionibacterium acnes). Continue reading “Management of Acne Vulgaris”
The updated American College of Cardiology/American Heart Association (ACC/AHA) Guideline on the Treatment of Blood Cholesterol (GTBC) has been long-awaited since the latest update of the Adult Treatment Panel III (ATP III) guidelines in 2004. The updated GTBC recommends a significant paradigm shift in lipid-loweringdrug therapy for atherosclerotic cardiovascular disease (ASCVD) risk reduction, which has led to questions regarding their content and their implementation.
Continue reading “Summary of the ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce ASCVD”
The autosomal recessive inherited primary hyperoxalurias types I, II and III are caused by defects in glyoxylate metabolism that lead to the endogenous overproduction of oxalate.
Continue reading “Features and Treatment of the Inherited Primary Hyperoxalurias”
Primary infection with varicella–zoster virus (VZV) results in chickenpox, characterized by viremia with a diffuse rash and seeding of multiple sensory ganglia, where the virus establishes lifelong latency. Herpes zoster is caused by reactivation of latent VZV in cranial-nerve or dorsal-root ganglia, with spread of the virus along the sensory nerve to the dermatome.
Continue reading “Indications for Antiviral Treatment in Patients with Herpes Zoster”
The finding of hypercalcemia on routine biochemical testing or in the evaluation of postmenopausal women with osteoporosis is typically the initial clue to the diagnosis of primary hyperparathyroidism. The total serum calcium level, which combines both the free and albumin-bound components of circulating calcium, should be adjusted for the level of albumin. Measurement of ionized calcium may be useful in selected cases, such as in patients with hyperalbuminemia, thrombocytosis, Waldenström’s macroglobulinemia, and myeloma; these patients may have elevated levels of total serum calcium, but normal levels of ionized serum calcium (artifactual hypercalcemia).
Continue reading “Guidelines for the Treatment of Asymptomatic Primary Hyperparathyroidism”
Differentiated thyroid cancer (DTC) is defined as a carcinoma deriving from the follicular epithelium and retaining basic biological characteristics of healthy thyroid tissue, including expression of the sodium iodide symporter (NIS), the key cellular feature for specific iodine uptake.
Continue reading “Indications and Contraindications Radioiodine Treatment of Differentiated Thyroid Cancer (DTC)”
In contrast to macroadenomas, for which therapy is routinely indicated, microadenomas do not always require treatment. For patients with microadenomas who do not have these indications, symptoms and prolactin levels can be monitored, and MRI can be used to follow the size of the tumor.
Continue reading “Indications for Therapy and for Neurosurgery in Patients with Prolactinomas”
- Initiating treatment with methotrexate or Arava (leflunomide) was recommended for most rheumatoid arthritis patients.
- Methotrexate plus Plaquenil (hydroxychloroquine) was recommended for rheumatoid arthritis patients with moderate to high disease activity.
Continue reading “The 2008 ACR Recommendations for Rheumatoid Arthritis Treatments”
- Diagnosis of sarcoidosis is firm when chest radiographic evidence is accompanied by compatible clinical features and noncaseating granulomas on biopsy, with all other causes of granulomas ruled out.
- Biopsy is indicated for all patients presumed to have sarcoidosis, except those with Löfgren’s syndrome.
Continue reading “Diagnosis, Clinical Characteristics, and Treatment of Sarcoidosis”