Missouri medicine
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Infections caused by community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) have become epidemic over the last decade. It causes a spectrum of diseases in humans but skin and soft tissue infections predominate. Molecular virulence factors in CA-MRSA are incompletely understood. In this article, the epidemiology, presentation, treatment, and surveillance of skin and soft tissue infections due to CA-MRSA are reviewed.
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The medical interview is an access point for contacting patients at the core of their being. Patients with concernfull medical problems initially and unreflectively grasp these conflicted situations directly in terms of their meaning for the self. The situation and the self can become fused transparently. ⋯ Imagine yourself connecting daily with patients at a meaningful level to get their health concerns handled and then another and then another. Doing otherwise creates tiredness and burnout. Connection even for a brief moment produces the powerful enchantment of presence for patients and physicians.
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Headache is a very common presenting complaint in the Emergency Department (ED). While the vast majority of these have benign or self-limited etiologies, there are several life or organ threatening causes that must be excluded. ⋯ Evidence-based recommendations for which patients should receive imaging in the ED are reviewed. Current diagnostic approaches and controversies in meningitis and subarachnoid hemorrhage are discussed.
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Thrombophilia is a tendency for venous thromboembolism (VTE) and it can be acquired or hereditary. Knowledge about hereditary thrombophilia (HT) has increased in the last two decades and this has lead to widespread testing of HT in patients with VTE. A comprehensive evaluation of HT can be complex. This article reviews the currently established hereditary thrombophilic disorders and discusses the potential usefulness and implications of testing for thrombophilia.