Pub Date : 2022-01-01DOI: 10.25270/con.2022.07.000019
Rachel Ruda, Ford M. Lannan, K. Handfield
A 26-year-old man with no significant medical history presented to our clinic with an area of hair loss on his posterior scalp (Figure). He reported first noticing the hair loss 4 years prior to presentation and denied any changes to the area or development of new lesions since onset. He denied any associated symptoms, including pruritus or tenderness. A physical examination was notable for a 2.0 × 1.5 cm oval, slightly depressed, partially hairless patch on the occipital scalp. Trichoscopy demonstrated a normal scalp with vellus hairs scattered throughout the patch.
{"title":"Occipital Hair Loss in a 26-Year-Old Man","authors":"Rachel Ruda, Ford M. Lannan, K. Handfield","doi":"10.25270/con.2022.07.000019","DOIUrl":"https://doi.org/10.25270/con.2022.07.000019","url":null,"abstract":"A 26-year-old man with no significant medical history presented to our clinic with an area of hair loss on his posterior scalp (Figure). He reported first noticing the hair loss 4 years prior to presentation and denied any changes to the area or development of new lesions since onset. He denied any associated symptoms, including pruritus or tenderness. A physical examination was notable for a 2.0 × 1.5 cm oval, slightly depressed, partially hairless patch on the occipital scalp. Trichoscopy demonstrated a normal scalp with vellus hairs scattered throughout the patch.","PeriodicalId":35575,"journal":{"name":"Consultant","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69418483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.25270/con.2022.07.000021
Jeffrey Budd
Background. Along with the global prevalence of obesity, the associated health and economic impacts are rapidly multiplying. The challenge to primary care is to identify and treat obesity as a chronic disease. Patients should receive specific advice about diet, lifestyle, and physical activity rather than a vague or terse recommendation to simply eat less and exercise. Regular monitoring and follow-up visits are critical, as with any chronic disease. When nonpharmacologic methods do not lead to weight loss, select patients should be offered supplementary pharmacotherapy. Bariatric surgery is a safe and effective treatment for some patients with persistent severe obesity or obesity with complications despite nonpharmacologic efforts and medications.
{"title":"Adult Obesity Management for Primary Care","authors":"Jeffrey Budd","doi":"10.25270/con.2022.07.000021","DOIUrl":"https://doi.org/10.25270/con.2022.07.000021","url":null,"abstract":"Background. Along with the global prevalence of obesity, the associated health and economic impacts are rapidly multiplying. The challenge to primary care is to identify and treat obesity as a chronic disease. Patients should receive specific advice about diet, lifestyle, and physical activity rather than a vague or terse recommendation to simply eat less and exercise. Regular monitoring and follow-up visits are critical, as with any chronic disease. When nonpharmacologic methods do not lead to weight loss, select patients should be offered supplementary pharmacotherapy. Bariatric surgery is a safe and effective treatment for some patients with persistent severe obesity or obesity with complications despite nonpharmacologic efforts and medications.","PeriodicalId":35575,"journal":{"name":"Consultant","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69418516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.25270/con.2022.07.00006
Ethan Loftspring, Karen Cuartas, Brandon Hood, D. Lin
Background. We present a case of a 29-year-old woman admitted to the hospital with hidradenitis suppurativa and found to have Staphylococcus lugdunensis bacteremia . Due to concern for the pathogenicity of this organism and recurrence of her axillary infection, a transthoracic echocardiogram was performed. The results did not demonstrate endocarditis. She was successfully treated with a course of oral doxycycline and topical agents. In contrast to other coagulase-negative staphylococci (CoNS), S lugdunensis has been shown to have a virulence pattern rivaling that of Staphylococcus aureus . It is important to educate clinicians on prompt management and treatment when patients are found to be bacteremic with this organism, as it can cause deep-seated and suppurative infections.
{"title":"Staphylococcus lugdunensis Infection of the Bilateral Axillaries","authors":"Ethan Loftspring, Karen Cuartas, Brandon Hood, D. Lin","doi":"10.25270/con.2022.07.00006","DOIUrl":"https://doi.org/10.25270/con.2022.07.00006","url":null,"abstract":"Background. We present a case of a 29-year-old woman admitted to the hospital with hidradenitis suppurativa and found to have Staphylococcus lugdunensis bacteremia . Due to concern for the pathogenicity of this organism and recurrence of her axillary infection, a transthoracic echocardiogram was performed. The results did not demonstrate endocarditis. She was successfully treated with a course of oral doxycycline and topical agents. In contrast to other coagulase-negative staphylococci (CoNS), S lugdunensis has been shown to have a virulence pattern rivaling that of Staphylococcus aureus . It is important to educate clinicians on prompt management and treatment when patients are found to be bacteremic with this organism, as it can cause deep-seated and suppurative infections.","PeriodicalId":35575,"journal":{"name":"Consultant","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69418529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.25270/con.2022.08.000005
F. Cooper, N. Mathews, Gift Kopsombut
{"title":"Recurrent Abdominal Pain in a Boy With Delayed Appearance of Palpable Purpura","authors":"F. Cooper, N. Mathews, Gift Kopsombut","doi":"10.25270/con.2022.08.000005","DOIUrl":"https://doi.org/10.25270/con.2022.08.000005","url":null,"abstract":"","PeriodicalId":35575,"journal":{"name":"Consultant","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69418900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.25270/con.2022.11.000006
A. Wei, Melva Navarro, Violet Yeager, Bishoy Goubran, R. A. Moran
{"title":"Naltrexone as an Adjunctive Treatment for Adolescents With Deliberate Self-Harm Behavior and Cannabis Use: A Case Series","authors":"A. Wei, Melva Navarro, Violet Yeager, Bishoy Goubran, R. A. Moran","doi":"10.25270/con.2022.11.000006","DOIUrl":"https://doi.org/10.25270/con.2022.11.000006","url":null,"abstract":"","PeriodicalId":35575,"journal":{"name":"Consultant","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69421372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.25270/con.2022.11.000012
Melissa M Warne, D. Buscaglia
{"title":"Right Lower Eyelid and Cheek Tenderness and Swelling","authors":"Melissa M Warne, D. Buscaglia","doi":"10.25270/con.2022.11.000012","DOIUrl":"https://doi.org/10.25270/con.2022.11.000012","url":null,"abstract":"","PeriodicalId":35575,"journal":{"name":"Consultant","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69422169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.25270/con.2022.11.000013
K. Craddock, Reshma Gupta, S. Louie, B. Kuhn
{"title":"Pulmonary Pitfalls: The Case of the \"Frequent Exacerbator\" with COPD","authors":"K. Craddock, Reshma Gupta, S. Louie, B. Kuhn","doi":"10.25270/con.2022.11.000013","DOIUrl":"https://doi.org/10.25270/con.2022.11.000013","url":null,"abstract":"","PeriodicalId":35575,"journal":{"name":"Consultant","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69422214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.25270/con.2022.02.00004
K. Carmichael
Glucagon-like peptide 1 (GLP-1) agonists are an important class of medications for patients with type 2 diabetes and should be considered for long-term therapy. A study of noninsulin treatment of type 2 diabetes in the United States showed that there has been a gradual decline in metformin use (from 57.0% in 2015 to 46.0% in 2019), an increase of GLP-1 agonist monotherapy use (from 4.3% in 2015 to 8.5% in 2019), and an increase in overall combined therapy use (from 9.8% in 2015 to 18.2% in 2019).1 Adequate management of diabetes with safe glycemic control is essential for reducing progression of chronic kidney disease, cardiovascular disease, and nonalcoholic fatty liver disease (NAFLD).
{"title":"What Do You Need to Know About GLP-1 Receptor Agonists?","authors":"K. Carmichael","doi":"10.25270/con.2022.02.00004","DOIUrl":"https://doi.org/10.25270/con.2022.02.00004","url":null,"abstract":"Glucagon-like peptide 1 (GLP-1) agonists are an important class of medications for patients with type 2 diabetes and should be considered for long-term therapy. A study of noninsulin treatment of type 2 diabetes in the United States showed that there has been a gradual decline in metformin use (from 57.0% in 2015 to 46.0% in 2019), an increase of GLP-1 agonist monotherapy use (from 4.3% in 2015 to 8.5% in 2019), and an increase in overall combined therapy use (from 9.8% in 2015 to 18.2% in 2019).1 Adequate management of diabetes with safe glycemic control is essential for reducing progression of chronic kidney disease, cardiovascular disease, and nonalcoholic fatty liver disease (NAFLD).","PeriodicalId":35575,"journal":{"name":"Consultant","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69417557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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