Postgraduate medicine
-
Even though significant progress has been made in understanding migraine headache pathophysiology and bringing new therapeutic options into practice, migraine remains underdiagnosed and undertreated in the United States. This paper couples recent research and expert opinion to provide practical guidance on the diagnosis of migraine for the primary care setting, where many patients first seek medical care for headache. Headache diagnosis in the primary care setting entails differentiating primary from secondary headache. ⋯ A brief but complete neurological history should be taken as well as performing physical and neurological examinations. When diagnosing the patient with headache, the clinician should be alert to the possible presence of chronic daily headache arising from medication overuse or uncontrolled migraine. Additionally, patient diaries and disability assessment tools can help identify a pattern of headaches and headache-related disability suggestive of migraine or medication-overuse headache.
-
Postgraduate medicine · May 2005
ReviewCurbing the psoriasis cascade. Therapies to minimize flares and frustration.
Psoriasis, a T-cell-mediated disorder, affects 1% to 3% of the world's population. The characteristic lesions occur in many different forms, can cause significant discomfort and social distress, and in some instances, lead to dehydration and metabolic derangement. ⋯ However, topical and systemic drug therapies and phototherapy can help minimize the exacerbations and prolong remissions. In this article, Dr Shenenberger outlines treatment approaches and discusses research into the use of immunomodulatory agents.