Missouri medicine
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The predictors of community-acquired methicillin resistant Staphylococcus aureus (CA-MRSA) in hospitalized patients based on their clinical presentation are limited. The aim of our study was identification of predictors of CA-MRSA infections based on clinical features in patients admitted to the hospital for skin and soft tissue infections. We retrospectively collected data over a period of two years at a single tertiary teaching institution. Younger age and presence of fever may be significant predictors of CA-MRSA.
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Despite advances in pain management research and technology, physicians are constantly challenged by patients with chronic pain who appear to require narcotics to function. This article assists physicians in making appropriate decisions regarding when to start long-term opioid therapy. The concept of a triage system will also be introduced to help in identifying high-risk patients and offer recommendations and appropriate referral for these patients.
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Acute and chronic pulmonary complications are a very important cause of morbidity and mortality in sickle cell disease. The Acute Chest Syndrome (ACS) is the most common form of acute pulmonary disease and will be reviewed in this article. ⋯ The development of pulmonary hypertension is a very important cause of chronic pulmonary disease and contributes to mortality. Because of the increased numbers of sickle cell patients living to adulthood, it is important for primary care providers to become familiar with these complications.
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Management of the solitary pulmonary nodule confronts physicians routinely. The key to management is to send patients with a malignant nodule for resection early, at the same time avoiding unnecessary surgery for patients with a benign nodule. After obtaining a thorough history and prior radiographs, the next best step is to obtain a chest CT. Depending on the probability of malignancy, the appropriate strategy can be determined and carried out.