Latest Articles
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Med. Clin. North Am. · Mar 2025
ReviewAdvances in Diagnosis and Management of Atypical Demyelinating Diseases.
The last two decades have seen tremendous progress in understanding central nervous system (CNS) demyelinating diseases, heralding an exciting new era for the diagnosis and treatment of patients with a variety of non-multiple sclerosis neuroinflammatory diseases. This article comprehensively reviews atypical CNS demyelinating diseases, beginning with the general approach to CNS demyelination, continuing with suggestions to facilitate the initial evaluation, and followed by a discussion about specific diseases (neuromyelitis optica, myelin oligodendrocyte glycoprotein antibody disease, acute disseminated encephalomyelitis, iatrogenic CNS demyelination, and transverse myelitis). MRI examples of these disorders are provided to illustrate key radiographic findings. The article concludes with recommendations for treatment.
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Head and neck cancers are heterogenous cancers with rising incidence of treatable/curative cancers. They are treated comprehensively by multidisciplinary teams. Survivors of head and neck cancers often deal with the sequalae of therapy and with increasing survival rates, it is anticipated that the primary care physicians are going to encounter more patients in their clinics in the coming years. The clinicians should be aware of physiologic and functional changes in vital organs involving daily activities such as eating, drinking, speech and communication, and also be prepared to be a part of the cancer survivorship plans.
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While pharyngitis is a common primary care complaint, evidence reveals that this diagnosis is an area where antibiotic therapy is frequently misused. Appropriate diagnosis and management of pharyngitis is crucial to ensure antimicrobial stewardship and improve patient safety and outcomes. Pharyngitis etiologies include both infectious and noninfectious sources such as bacteria, viruses, fungal organisms, trauma, irritants, laryngopharyngeal reflux, and medications. Clinicians need to obtain a thorough history and careful physical examination, along with appropriate diagnostic testing when indicated, to ensure treatment plans are targeted toward the most likely pharyngitis etiology.
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To compare access, quality, and clinical outcomes between Latino and non-Latino White Californians with colon cancer. ⋯ Latino patients with colon cancer experienced delays, segregation, and lower receipt of recommended care. Hospital-level colectomy volume appears to be strongly associated with access, quality, and survival-especially for patients who identify as Latino-suggesting that directing at-risk patients with cancer to high-volume hospitals may improve health equity.
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Geographic origin may represent a variable capable of influencing health status. This study aims to investigate the presence of differences of disease severity in Italian patients with fibromyalgia from different macro-regions. ⋯ This is the first study to demonstrate geographical origin-dependent intra-national differences in the severity of fibromyalgia. The results confirm the necessity of considering fibromyalgia within the context of the biopsychosocial model and of implementing healthcare policies targeted towards the most underserved regions.