February 2012

Talking to patients: Barriers to overcome

by: MANDELL, B. F.

Posttraumatic stress disorder, depression, and suicide in veterans

by: SHER, L., BRAQUEHAIS, M. D., CASAS, M.

Suicidal behavior is a critical problem in war veterans. Combat veterans are not only more likely to have suicidal ideation, often associated with posttraumatic stress disorder (PTSD) and depression, but they are more likely to act on a suicidal plan. Especially since veterans may be less likely to seek help from a mental health professional, non-mental-health physicians are in a key position to screen for PTSD, depression, and suicidal ideation in these patients. The authors discuss the association of PTSD, depression, and suicide in veterans, keys to assessment of suicide risk, and interventions.

A 48-year-old woman with an ecchymotic rash

by: CHATTERJEE, S., TUTHILL, R. J.

Chest pain followed by sudden collapse

by: OMAR, H. R.

Deep brain stimulation: What can patients expect from it?

by: MACHADO, A., FERNANDEZ, H. H., DEOGAONKAR, M.

Deep brain stimulation has largely replaced ablative procedures for the treatment of advanced Parkinson disease, essential tremor, and dystonia. It is also approved for obsessive-compulsive disorder. Although not curative, it improves symptoms and quality of life.

Finding the cause of acute kidney injury: Which index of fractional excretion is better?

by: GOTFRIED, J., WIESEN, J., RAINA, R., NALLY, J. V.

The fractional excretion of urea (FEU) is a useful index for differentiating the main categories of causes of acute kidney injury, ie, prerenal causes and intrinsic causes. It may be used in preference to the more widely used fractional excretion of sodium (FENa) in situations in which the validity of the latter is limited, such as in patients taking a diuretic.

Overcoming health care disparities via better cross-cultural communication and health literacy

by: MISRA-HEBERT, A. D., ISAACSON, J. H.

Health care disparities have multiple causes; the dynamics of the physician-patient encounter is one of the causes that can be modified. Here, we discuss specific recommendations related to cross-cultural communication and health literacy as practical steps to providing more equitable health care to all patients.

New and future therapies for lupus nephritis

by: APPEL, G. B.

Based on data from randomized controlled trials over the past decade, oral mycophenolate (CellCept) now rivals intravenous cyclophosphamide (Cytoxan) as a first-line therapy for lupus nephritis, offering similar efficacy but less toxicity. The roles of rituximab (Rituxan) and new immunomodulatory agents are being explored. Creativity in treating lupus nephritis is needed; one regimen does not fit all.

A 37-year-old man with a chronic cough

by: PATEL, S. M., PATEL, S. S., MYERS, R.