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DERMATOLOGY CASE CHALLENGE: A diabetic patient with longstanding, expanding pretibial plaques
A 37-year-old woman presents with plaques of 1 year's duration on her lower legs that appear to be expanding. The patient has a history of poorly controlled diabetes mellitus requiring insulin but is otherwise well and taking no other medications. The clinician suspects granuloma annulare, cellulitis, sarcoidosis, xanthomas, necrobiosis lipoidica diabeticorum, and necrobiotic xanthogranuloma.
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Challenging equation: 1 toddler + 1 teen X (irritable and hypertensive) =2(D), where "D" is a diagnostic dilemma!
A 22-month-old girl with behavioral changes and hypertension, and a 16-year-old boy with generalized weakness, lower-extremity pain, and fasciculations.
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THE 15-MINUTE VISIT: Sleep apnea
A guide to patient encounters in the real world of office practice.
Despite being a common disease, obstructive sleep apnea (OSA) is often overlooked by physicians. It is characterized by recurrent episodes of upper airway collapse and obstruction during sleep.
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Put your family first
As holiday preparations and your practice intrude on your time with loved ones, keep this doctor's words in mind.
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