Heartburn in practice

Patient perspectives I’ve been having trouble with heartburn. In fact, it is one of the reasons I wanted to lose weight. I used to get it every once in a while, but then it started to get more…

Hepatitis C

Epidemiology Hepatitis C virus, identified in 1988, is an RNA virus that appears to be responsible for most instances of parenterally transmitted non-A, non-B hepatitis. The virus seems to mutate frequently and appear in many subtypes. Table 49-6…

Non-steroidal Anti-inflammatory Drugs (NSAIDs)

How many of your patients chronically take non-steroidal anti-inflammatory drugs (NSAIDs)? In a recent Saskatchewan survey, approximately 13% of the general population had filled a prescription for an NSAID during the preceding year. In British Columbia these drugs…

Pathogenesis Of Joint Damage

Although the cause of rheumatoid arthritis remains elusive, the destructive features of the disease have been extensively documented and described. The following sections review each key element of disease pathogenesis. They include the infiltration of lymphocytes and macrophages…

Could the Blues Increase Your Risk for Stroke?

Many factors that put individuals at risk for stroke have been identified, including physical inactivity, high cholesterol, obesity, use of alcohol or cigarettes, diabetes and high blood pressure. For the first time, researchers have identified a psychological factor…

Treatment/Clostridium difficile Infection and Pseudomembranous Colitis

Case A 68-year-old woman complained of a 2-week history of loose stool and abdominal cramps. One month ago she was treated by her primary care physician for a sinus infection with amoxicillin. In addition to diarrhea, she noticed…

Treatment of Inflammatory Bowel Disease

Diet and nutrition. Patients with mild symptomatic Inflammatory bowel disease usually are able to take food orally. The diet should be nutritious. Traditionally, fiber has been restricted during periods of active symptoms. Some patients cannot tolerate milk, which…

Depression: Nutrition and Mental Health

The brain’s emotional mechanism is not completely understood, but research shows that the relationship between food and mood makes up one of the brain-body links. Mood seems to be influenced by the neurotransmitter serotonin, the lack of which…

Corticotropin-Releasing Factor Receptor Antagonists.Chloride-Channel Activators

Corticotropin-Releasing Factor Receptor Antagonists Overview Corticotropin-releasing factor (CRF) is a peptide that functions as a neurotransmitter in the brain. It plays a critical role in coordinating the body’s overall response to stress, and it interacts with two known…

Therapeutics/Acute Pancreatitis and Peripancreatic Fluid Collections

Case A 44-year-old woman presented with severe epigastric pain requiring administration of narcotic agents. Abdominal ultrasound revealed multiple small gall stones. The common bile duct was not dilated. Serum amylase and lipase values were five times the upper…