A variety of highly effective agents for primary insomnia are currently available including benzodiazepines, benzodiazepine receptor agonists, and other classes. Agents that impact the benzodiazepine receptors (i.e., either benzodiazepines or benzodiazepine receptor agonists) are controlled substances and have occasional problematic issues such as misuse, diversion, cognitive clouding, and rebound upon withdrawal.
I remember when the Goldman myocardial infarction (MI) algorithm came out, quickly followed by a seven-button hand-held "calculator." It promised to reduce all decision-making regarding ED chest pain patients to seven yes or no questions. But when you looked into the mathematics, if you answered no or negative to all of the questions, it indicated a 4% chance of acute cardiac ischemia. So, what would you do with this information? Could you tell the patient that there was only a 4% chance of a heart attack, so it was OK to go home?
A significant portion of patients with irritable bowel syndrome will test positive for celiac disease.
Correlation of 6 different immunochemical qualitative fecal occult blood tests with colonoscopy findings showed wide variation in diagnostic performance.
Weight management issues continue to be problematic for persons with type 2 diabetes.
The ECG above was obtained from a 62-year-old man with hypertension who was being seen in the office. How would you interpret this tracing if he had told you of some chest discomfort that he felt for the first time earlier that morning?
