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April 2005


Features

Overactive Bladder: When and How to Treat and When to Refer
  by David Mobley, MD, FACS & Neil Baum, MD
  Overactive bladder is a common, debilitating condition. Patients often feel uncomfortable or unwilling to mention the symptoms, and physicians should ask relevant questions to elicit the history of patients at risk. The most important part of the evaluation is the medical history, which is used to identify any of the numerous conditions that can cause overactive bladder or contribute to the symptoms. Anticholinergic medications are the cornerstone of therapy, with the newer, extended-release formulations generally having fewer side effects. Behavioral therapy to modify abnormal voiding patterns is a valuable therapeutic adjunct.
Acquired Angioedema: A Challenging Diagnosis
  by Atul Kukar, DO; Rashmi Chawla, MD; Ira Finegold, MD
  Angioedema is a hypersensitivity disorder that presents as edema of the subcutaneous tissues and mucosa, typically involving the upper airways or gastrointestinal tract, and often accompanied by urticaria. Although this condition could be either hereditary or acquired, the causes often overlap, with similar clinical manifestations. Diagnosis requires laboratory testing to determine serum complement levels. Treatment must be directed toward the resolution of the acute symptoms and prevention of recurrence.
Contemplating Suicide: A Physician's Guide to Dealing with the Suicidal Patient
  by J. Dan Johnson, DO; Lisa Riddlebarger, MS, LPC
  Suicide is often viewed as "a permanent fix to a temporary problem." Unfortunately, for many individuals, attempting suicide is the answer. Estimates suggest there are from 8 to 25 suicide attempts for every one completion. As more lethal methods are used, the number of completed suicides increases. Physicians often see patients in the month before completion of the act. To provide effective treatment, they must be aware of the risks, particularly the red flags that indicate imminent risk in their patients.
  Case Report & Commentary
An Unusual Case of Chylothorax in an HIV-infected Patient with Kaposi's Sarcoma
  by Mitchell L. Margolis, MD; Eileen B. MacDonald, MD; Phillip Green, MD; Gregg Y. Lipschik, MD; Guest Editor: H. Ralph Schumacher, Jr, MD
  Editorial
Is It Time to Begin Routine Screening for HIV Infection?
  by Jeffrey T. Kirchner, DO


Departments

  Photo Quiz
Gastroenterology Quiz
  Prepared by Natalia Keyser, MD, and Gloria Fioravanti, DO, FACP
  Picture Perfect
Pruritic Plaques in a Man with AIDS
  by Series Editor: Herbert L. Fred, MD
  ECG Rounds
Cardiac-related Syndromes that Mimic Ischemia in the Pediatric ECG
  by Frank A. Paul, DO, FACOEP, FACEP; Eileen M. Pokriefka, DO, FAAP; Craig R. Wallingford, DO, FACOFP; Joanne Mozuras, MS, CNM
  Code Blue: News for Resident Physicians
Better Working Conditions Begin with You

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