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Angioedema is a side effect that is often associated with the use of angiotensin-converting enzyme (ACE) inhibitor medications. These medications result in increased levels of circulating bradykinins. This case illustrates the result of a local traumatic event to the upper lip, presumably causing marked bradykinin release in a patient who was taking an ACE(More)
BACKGROUND Recent studies suggest that the self-monitoring of blood pressure (SMBP) may improve the identification and control of hypertension. Although endorsed by the Joint National Committee VII guidelines, home monitoring is not currently part of the standard care of hypertension. OBJECTIVE To assess community- and university-based primary care(More)
Eczema herpeticum (EH), a form of Kaposi's varicelliform eruption, is the dissemination of herpes simplex virus in the setting of preexisting eczema. We discuss the case of an 18-year-old woman with underlying atopic dermatitis (AD) who presented to an Emergency Department complaining of malaise, fever, and a spreading, burning, vesiculopapular facial rash.(More)
Knowledge of the anatomy and function of the nail apparatus is essential when performing the physical examination. Inspection may reveal localized nail abnormalities that should be treated, or may provide clues to an underlying systemic disease that requires further workup. Excessive keratinaceous material under the nail bed in a distal and lateral(More)
The telephone, a ubiquitous instrument in the practice of medicine, continues to have new applications for clinical practice. The goals of the ever-increasing managed care environment appear to fit nicely with these applications. Heightened attention toward telephone education, protocol development, and documentation are needed. This article reviews(More)
Self-monitoring of blood pressure actively involves patients in hypertension management. However, the usefulness of self-monitoring of blood pressure may be limited by inaccurate patient reporting. The study objective was to assess reliability of patient blood pressure reporting over 6 months. Forty-nine subjects with Joint National Committee stage 1 or 2(More)
The significant resurgence of bedbugs in the past decade has been attributed to pesticide resistance, more frequent travel, lack of public awareness, and inadequate pest control programs. Bedbugs are obligate blood parasites (insect family Cimicidae). They can withstand a large range of temperatures but are attracted to warmth and carbon dioxide. They(More)
Edema is an accumulation of fluid in the interstitial space that occurs as the capillary filtration exceeds the limits of lymphatic drainage, producing noticeable clinical signs and symptoms. The rapid development of generalized pitting edema associated with systemic disease requires timely diagnosis and management. The chronic accumulation of edema in one(More)
To confidently diagnose and treat Lyme disease, the clinician must first understand the natural history of this disease, especially its protean early manifestations. Emergency physicians, primary care physicians, and other providers need to be vigilant in terms of the timely recognition of erythema migrans (EM), the unique marker of early localized stage 1(More)