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Cervical RadiculopathyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Neck pain is a common complaint in the U.S. It is estimated that 30%-50% of adults will experience neck pain in a given year. Neck and back pain together account for about 65% of cases of disability, although neck pain less frequently leads to disability claims. Interestingly, neck pain has the highest frequency in those working in hospitals and offices, while those working in industrial/service and forestry sectors have the lowest frequency of neck pain. Women tend to have higher rates of trauma-related neck pain and demonstrate greater spinal motions. This may be related to men having anatomically wider and longer disk f...
Source: Disease a Month - November 17, 2009 Category: Infectious Diseases Authors: Daniel Roth, Ai Mukai, Priya Thomas, Thomas H. Hudgins, Joseph T. Alleva Source Type: journals

Cervical Facet Mediated PainEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The Quebec Task Force on Whiplash-Associated Disorders defines whiplash as an acceleration-deceleration mechanism of energy transfer to the neck most often resulting from rear- or side-impact motor vehicle collisions; the impact often results in bony or soft-tissue injuries, which are referred to as whiplash injury. The varied symptoms arising from whiplash injury are termed whiplash associated disorders (WAD). (Source: Disease a Month)
Source: Disease a Month - November 17, 2009 Category: Infectious Diseases Authors: Katherine White, Thomas H. Hudgins, Joseph T. Alleva Source Type: journals

Cervical Sprain/Strain DefinitionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Cervical sprain/strain typically refers to acute pain arising from injured soft tissues of the neck, including muscles, tendons, and/or ligaments. The most common event leading to such injuries are motor vehicle collisions. The mechanism of injury is complex. Basically, when a vehicle is struck from behind, the initial head and neck acceleration lag behind vehicular acceleration. Eventually, head and neck acceleration reaches up to 2 and a half times the maximum car acceleration, which subsequently results in dramatic deceleration at end range of motion of the neck. While such injury can also result in fracture, discogenic...
Source: Disease a Month - November 17, 2009 Category: Infectious Diseases Authors: Katherine White, Thomas H. Hudgins, Joseph T. Alleva Source Type: journals

ForewordEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In a previous issue, the authors discussed the pain generators in the lumbar spine that result in low back pain. Being part of the spinal column, the cervical spine has the same pain generators: paraspinal muscles, ligaments, nerve root, outer third of the intervertebral disk, periosteum, and facet joint; these are all discussed in this issue. However, the cervical spine does have several differences from the lumbar spine, which has clinical implications. The spinal cord is within the cervical spine, unlike the lumbar spine, where the cord ends at L1 in adults. The facet joints are oriented differently, allowing for more r...
Source: Disease a Month - November 17, 2009 Category: Infectious Diseases Authors: Thomas H. Hudgins, Joseph T. Alleva, Jerrold B. Leikin Source Type: journals

Table of ContentsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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Source: Disease a Month - November 17, 2009 Category: Infectious Diseases Source Type: journals

Information for ReadersEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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Source: Disease a Month - November 17, 2009 Category: Infectious Diseases Source Type: journals

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Source: Disease a Month - November 17, 2009 Category: Infectious Diseases Source Type: journals

Editorial BoardEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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Source: Disease a Month - November 17, 2009 Category: Infectious Diseases Source Type: journals

Treatment of SarcoidosisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Sarcoidosis presents unique challenges regarding treatment decisions. Most patients will not require treatment because their disease is discovered incidentally. Others improve with or without therapy, due to a high rate of spontaneous remission. Most importantly, because the cause of sarcoidosis is unknown, no specific therapy exists. Instead we are left with medications that globally suppress the immune system, bringing the undesired consequences of immunosuppression along with other side effects. Despite its original description over 100 years ago by Hutchinson, and over 6700 references on “sarcoidosis treatment” in ...
Source: Disease a Month - October 27, 2009 Category: Infectious Diseases Authors: Christopher S. King, William Kelly Source Type: journals

Diagnosis of SarcoidosisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The “protean” manifestations of the granulomatous disease sarcoidosis have been commented upon since the formative descriptions by Hutchinson, Carl and Caesar Beock, Besnier and others beginning more than 100 years ago. The first world conference on sarcoidosis took place in 1958 at Brompton Hospital (). Despite early and subsequent concerted effort, however, the causative agent has not yet been discovered. The diagnosis of sarcoidosis, therefore, relies on the identification of characteristic clinical, radiologic, and pathologic findings as aids the diagnosis of other idiopathic interstitial pneumonias. Owing to the v...
Source: Disease a Month - October 27, 2009 Category: Infectious Diseases Authors: Scott Parrish, J.F. Turner Source Type: journals

Sarcoidosis: Extrathoracic ManifestationsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
While sarcoidosis is well known to affect the lungs, the most common extrathoracic involvement affects the skin, eyes, and liver, and the most life-threatening organ involvement includes the cardiac and neurologic systems. There is increasing recognition of sarcoidosis involvement of heart and musculoskeletal system with the advances in imaging techniques, such as gadolinium-enhanced magnetic resonance imaging (MRI), perfusion scanning, or positron emission tomography. Sarcoidosis of the skin was first described in 1877 by Hutchinson, and in the subsequent decades, sarcoidosis has been recognized as a multisystem disease. ...
Source: Disease a Month - October 27, 2009 Category: Infectious Diseases Authors: Jennifer Holmes, Angeline Lazarus Source Type: journals

Intrathoracic SarcoidosisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Sarcoidosis is a multisystem granulomatous inflammatory disorder of unknown etiology. Patients with dermatologic manifestations of sarcoidosis represented the initial cases described as “sarkoid” in the late 1800s; one of the classic presentations of sarcoidosis was described by Löfgren based on his descriptions in 1946. Although sarcoidosis is a multisystem disorder, the intrathoracic manifestations are both the most common and often most clinically significant. Although plain radiography will demonstrate either pulmonary parenchymal involvement and/or mediastinal lymph node involvement in about 90% of patients with ...
Source: Disease a Month - October 27, 2009 Category: Infectious Diseases Authors: Gregory Fuhrer, Janet N. Myers Source Type: journals

Sarcoidosis: Epidemiology, Etiology, Pathogenesis, and GeneticsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Sarcoidosis is a chronic systemic granulomatous disease of unknown etiology, most commonly affecting young adults. Hutchinson described the dermatological presentation of sarcoidosis in 1875. Boeck, for whom the disorder was later named, reported the histology of these lesions in 1899. Because the skin lesions resembled sarcoma but had benign histopathologic and clinical features, Boeck named the lesions “sarkoid.” Since then, several scientists have contributed to the current understanding of sarcoidosis as a systemic disease with protean clinical manifestations. The clinical course of sarcoidosis ranges from spontane...
Source: Disease a Month - October 27, 2009 Category: Infectious Diseases Authors: Angeline Lazarus Source Type: journals

IntroductionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Sarcoidosis is a multisystem disorder of unknown cause(s) that commonly affects young and middle-age adults worldwide. Its common presentations include bilateral hilar adenopathy, pulmonary infiltration, and skin and ocular lesions. There is significant variability in its clinical features and outcome among the different ethnic groups. The clinical manifestations are protean and can present in an acute, subacute, or chronic form. The clinical course is also variable from spontaneous resolution to progressive disease despite treatment. The diagnosis of sarcoidosis requires compatible clinical and radiological features and o...
Source: Disease a Month - October 27, 2009 Category: Infectious Diseases Authors: Angeline Lazarus Source Type: journals

ForewordEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Over the past several years, there have been multiple media reports of celebrities who have been living with (and succumbing to) sarcoidosis. Formerly thought to be a mysterious inflammatory lung disease, sarcoidosis has now entered the public consciousness. At one time, sarcoidosis was believed to be a rare pulmonary granulomatous disease; it is now recognized to be of higher prevalence in the African American and European (particularly Scandinavian) communities. As such, public awareness of this multisystem disease process with a variety of extrapulmonary manifestations has increased. (Source: Disease a Month)
Source: Disease a Month - October 27, 2009 Category: Infectious Diseases Authors: Jerrold B. Leikin Source Type: journals

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Source: Disease a Month - October 27, 2009 Category: Infectious Diseases Source Type: journals

Information for ReadersEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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Source: Disease a Month - October 27, 2009 Category: Infectious Diseases Source Type: journals

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Source: Disease a Month - October 27, 2009 Category: Infectious Diseases Source Type: journals

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Source: Disease a Month - October 27, 2009 Category: Infectious Diseases Source Type: journals

Herbal ToxicityEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In the USA, the popularity of using dietary supplements has been documented to escalate yearly. Since the passage of the US Dietary Supplement Health and Education Act of 1994, numerous studies have supported this increase. One study reported an increase of 380% in use of botanicals and dietary supplements in the USA during a 10-year period in the 1990s. In other areas of the world, dietary supplements and herbal medicines have been used for centuries. In the USA the definition of a dietary supplement is as follows: “the Food and Drug Administration (FDA) defines a dietary supplement to be a product (other than tobacco) ...
Source: Disease a Month - September 28, 2009 Category: Infectious Diseases Authors: Richard T. Tovar, Renee M. Petzel Source Type: journals

ForewordEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In a recent study by Suchard et al., physicians and medical students were surveyed regarding their knowledge of herbal medications. The study revealed that the study group had little training in herbal toxicities and drug interactions and they self-rated their familiarity with these topics as “poor.” In addition, the study group scored very low on an assessment quiz regarding these topics. The study concluded that better educational efforts might improve physician knowledge of the adverse effects of herbal remedies. Since that study, a variety of recent studies have verified the widespread use of complementary and alte...
Source: Disease a Month - September 28, 2009 Category: Infectious Diseases Authors: Michael Greenberg Source Type: journals

Table of ContentsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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Source: Disease a Month - September 28, 2009 Category: Infectious Diseases Source Type: journals

Information for ReadersEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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Source: Disease a Month - September 28, 2009 Category: Infectious Diseases Source Type: journals

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Source: Disease a Month - September 28, 2009 Category: Infectious Diseases Source Type: journals

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Source: Disease a Month - September 28, 2009 Category: Infectious Diseases Source Type: journals

SyncopeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
is best considered as a syndrome in which a relatively sudden-onset, brief, and self-terminating loss of consciousness results from a temporary period of global cerebral hypoperfusion. In this regard, many other conditions may also cause a temporary loss of consciousness (TLOC) (). In practical terms, patients who present with TLOC describe their symptoms in lay terms (which vary from country to country), such as “collapse” or “fall” or “blackout.” In such cases, “syncope” is only one possibility; the broad range of potential causes for real or presumed TLOC must be considered. Thus, epilepsy, concussions,...
Source: Disease a Month - August 26, 2009 Category: Infectious Diseases Authors: Rajat Jhanjee, Ilknur Can, David G. Benditt Source Type: journals

ForewordEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Syncope is one of the most common presentations to the primary care physician. This prevalent disorder can comprise up to approximately 1% of Emergency Department admissions and up to 6% of hospital admissions annually in the United States. These syncopal episodes may involve multiple systems including endocrine, metabolic, neurologic, and cardiovascular. Thus, the diagnostic approach to this physiological disorder can be complex, often involving complicated testing procedures with low yield. (Source: Disease a Month)
Source: Disease a Month - August 26, 2009 Category: Infectious Diseases Authors: Jerrold B. Leikin Source Type: journals

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Source: Disease a Month - August 26, 2009 Category: Infectious Diseases Source Type: journals

Information for ReadersEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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Source: Disease a Month - August 26, 2009 Category: Infectious Diseases Source Type: journals

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Source: Disease a Month - August 26, 2009 Category: Infectious Diseases Source Type: journals

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Source: Disease a Month - August 26, 2009 Category: Infectious Diseases Source Type: journals

The Multiple Organ Dysfunction SyndromeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The multiple organ dysfunction syndrome (MODS) arose paradoxically as the result of advances in supportive therapy, and in this sense MODS can be viewed as a “disease of medical progress.” The evolution of MODS may be more easily understood from the perspective of advances in resuscitation of combat injuries during the 20th century. In the First World War, many injured soldiers died as the consequence of hemorrhagic (wound) shock. During the Second World War, administration of whole blood by combat medics in the field reduced the incidence of wound shock but enabled the emergence of posttraumatic renal failure as a sig...
Source: Disease a Month - July 14, 2009 Category: Infectious Diseases Authors: Barry A. Mizock Source Type: journals

ForewordEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
When I was asked to write a forward about “MODS,” the acronym did not initially stir up a wealth of enthusiasm. In fact, I was not entirely sure what MODS stood for. So I looked at the manuscript and saw the title “Multiple Organ Dysfunction Syndrome” and I was at least savvy enough to connect the title to the acronym. While I intend this to be a bit tongue-in-cheek, I have to admit that I was uncertain of the level of interest that this subject would generate among our readers. Was this Disease-a-Month issue going to be of relevance to a large primary care audience? (Source: Disease a Month)
Source: Disease a Month - July 14, 2009 Category: Infectious Diseases Authors: Martin Lipsky Source Type: journals

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Source: Disease a Month - July 14, 2009 Category: Infectious Diseases Source Type: journals

Information for ReadersEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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Source: Disease a Month - July 14, 2009 Category: Infectious Diseases Source Type: journals

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Source: Disease a Month - July 14, 2009 Category: Infectious Diseases Source Type: journals

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Source: Disease a Month - July 14, 2009 Category: Infectious Diseases Source Type: journals

Clostridium difficileEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(C diff) is a Gram-positive, spore-forming, toxin-producing, anaerobic rod bacteria that results in millions of human infections worldwide annually. The annual incidence of C diff associated diarrhea (CDAD; some refer to it as C diff associated disease) in the USA is more than 250,000 cases, according to the Centers for Disease Control and Prevention (CDC). Clearly CDAD is emerging as one of the most significant hospital-acquired infections (HAI) among US and Canadian health care facilities (HCF) with increasing incidence rates. C diff was first linked to illness in 1978 when it was identified as the pathogen causing pseu...
Source: Disease a Month - June 25, 2009 Category: Infectious Diseases Authors: Robin B. McFee, George G. Abdelsayed Source Type: journals

Nosocomial or Hospital-acquired Infections: An OverviewEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Nosocomial or hospital-acquired infections (HAI) are a leading cause of morbidity and mortality in the USA. Several studies have been conducted over the years to characterize and quantify this ever-growing public health problem. In a 2002 study published in 2007, the estimated number of HAI in US hospitals, adjusted to include federal facilities, was 1.7 million, with almost 99,000 deaths directly resulting from the infection. The highest infection rates per 1000 patient-days occurred in intensive care units (ICU), followed by high-risk nurseries. Surgical site infections accounted for a significant number of infections. T...
Source: Disease a Month - June 25, 2009 Category: Infectious Diseases Authors: Robin B. McFee Source Type: journals

IntroductionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Patients have an expectation that they will receive appropriate medical care, especially at a modern hospital. They neither expect nor deserve to acquire an additional ailment during treatment, yet this is a likely exigency given medication errors, surgical mishaps, and infections. Despite tremendous advancements in technology and therapeutics, infections remain a leading cause of death worldwide and continue to afflict patients at health care facilities. Over the last few years, increasing numbers of headlines “dramatic rise in C diff deaths” and similar have appeared in both lay and medical literature. While there ar...
Source: Disease a Month - June 25, 2009 Category: Infectious Diseases Authors: Robin B. McFee Source Type: journals

ForewordEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Reports questioning the safety of hospitals began to appear in the 1990s. The Institute of Medicine reported, in 1999, that deaths attributable to medical errors in the form of incompatible transfusions, wrong site surgeries, medication errors, etc exceeded the number of deaths from breast cancer, motor vehicle accidents, and AIDS combined. (Source: Disease a Month)
Source: Disease a Month - June 25, 2009 Category: Infectious Diseases Authors: David D.K. Rolston Source Type: journals

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Source: Disease a Month - June 25, 2009 Category: Infectious Diseases Source Type: journals

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Source: Disease a Month - June 25, 2009 Category: Infectious Diseases Source Type: journals

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Source: Disease a Month - June 25, 2009 Category: Infectious Diseases Source Type: journals

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Source: Disease a Month - June 25, 2009 Category: Infectious Diseases Source Type: journals

Rhubarb and Oxalosis (Rheum Species)Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Although the petioles of rhubarb leaves have been a food source in modern times, the dried root or rhizome has been used as a medicinal herb since the third millennium BC. Chinese rhubarb is a traditional herb used as a purgative and bacteriocidal agent for dysentery. In the 16th and 17th centuries, Chinese rhubarb was coveted as a medicinal remedy that was superior to European varieties. During this time, Russian sources (the Commerce Collegium in St. Petersburg, the Rhubarb Commission on the Mongolian border) and the British East India Company supplied Europe with large quantities of rhubarb. This popular laxative was th...
Source: Disease a Month - May 19, 2009 Category: Infectious Diseases Authors: Donald G. Barceloux Source Type: journals

Potatoes, Tomatoes, and Solanine Toxicity (Solanum tuberosum L., Solanum lycopersicum L.)Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The Inca people first cultivated the potato in the Altiplano of the High Andes of Chile during prehistoric times. Spanish explorers brought the potato to Europe near the end of the 16th century. Although initially considered “peasant food,” the cultivation of the potato spread across Europe including continental Europe, Britain, and Ireland. By 1780, the potato became a staple crop in Ireland. Although cultivation of the potato contributed to the rapid expansion of the Irish population between 1750 and 1850, a famine began in the late 1840s as a result of a fungal-induced potato blight [Phytophthora infestans (Mont.) d...
Source: Disease a Month - May 19, 2009 Category: Infectious Diseases Authors: Donald G. Barceloux Source Type: journals

Pepper and Capsaicin (Capsicum and Piper Species)Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Mexican Indians probably used chili peppers long before the birth of Christ. The archaeologist, R. S. Macneish, found pepper seeds dating from about 7500 BC in Mexico. The physician, Chauca, on the second voyage of Columbus to the New World noted the culinary and medicinal use of chili peppers by Native Americans. Irritant smoke from the burning of chili peppers was a weapon used by Native Americans against invaders. Chemical investigations into the ingredients in chili peppers began in the early 19th century. In 1846, Thresh crystallized the active component in chili peppers, and he named the substance capsaicin. Nelson a...
Source: Disease a Month - May 19, 2009 Category: Infectious Diseases Authors: Donald G. Barceloux Source Type: journals

Nutmeg (Myristica fragrans Houtt.)Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Nutmeg probably was imported into Europe during the 12th century by Arab merchants. For many years, this spice has been used as an aromatic stimulant, abortifacient, antiflatulent, and as a means to induce menses. The Portuguese discovered the nutmeg tree on the Banda Islands of Indonesia (Spice Islands) in 1512. In 1576, de Lobel reported the first case of nutmeg intoxication in a pregnant English woman, who ingested 10-12 nutmeg nuts. Beginning in the 17th century, the Dutch controlled the Spice Islands, and they monopolized the spice trade until the British obtained nutmeg seedlings from the Banda Islands at the end of ...
Source: Disease a Month - May 19, 2009 Category: Infectious Diseases Authors: Donald G. Barceloux Source Type: journals

Grass Pea and Neurolathyrism (Lathyrus sativus L.)Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Carbonized fossils indicate that the grass pea was domesticated in the Near East, and then cultivated with cereals in the Balkans since the Neolithic period. Human lathyrism is a spastic lower-extremity paraplegia that has been associated with the ingestion of grass peas since the time of Hippocrates. The Duke of Wurttenberg prohibited the baking and consumption of bread containing grass peas in Germany during the late 17th century. In 1873, Cantani identified this neurological disease as lathyrism. Epidemics of neurolathyrism usually occur during times of food shortages, such as drought, flooding, or wars. Epidemics of ne...
Source: Disease a Month - May 19, 2009 Category: Infectious Diseases Authors: Donald G. Barceloux Source Type: journals