... disability. The individual muscle diseases differ in their age of onset, their rate of
progression and their pattern of weakness which in turn dictates the nature and extent ofthe
disability that they ... and the unknown differences in the type and severity ofthe epilepsy in the three
national groups.[12]
Other important factors to consider would be the distribution of specific muscle disease ... relationships with other close family
members. I require more from them.” – US patient.
Problems of access tothe homes of friends and family and to social venues were also a
source of difficulty...
... and other devices geared to improve the
patient& apos;s quality of life and ability to function in their own households.
The optometrist should provide thepatient written documentation of his ...
affecting the venules; it is seen as sheathed, attenuated retinal vessels.
Progression of pars planitis can lead to continued obliteration ofthe
vessels toward the posterior pole, together withthe ... Followup
The prognosis for thepatientwith a retinal break and the need for
followup by the optometrist depend on the type and severity ofthe break.
The frequency and composition of evaluation...
... not be performed because ofthe patient& apos;s generally
poor condition. We therefore applied a functional brace
with the hope that thepatient would be able to walk with
crutches. X-ray revealed ... plate osteosynthesis (MIPO) techniques mini-
mize the extent of soft tissue trauma tothe injury zone,
theoretically maintaining a better blood supply around
the fracture area. Treatment of fractures ... predispose patients to fracture. Delayed
union and non-union of fractures have been reported in patients with Paget's disease. Therefore, open reduction and
internal fixation of fractures...
... 052. ApproachtothePatient
with a Skin Disorder
(Part 1)
Harrison's Internal Medicine > Chapter 52. ApproachtothePatientwith
a Skin Disorder
APPROACH TOTHEPATIENTWITH ... Fig. 52-3) and to
formulate a differential diagnosis (Table 52-4). For instance, the finding of scaling
papules (present in patients with psoriasis or atopic dermatitis) places thepatient
in ... that the erosion is the primary lesion and the redness and scale
are secondary, while the correct interpretation would be that thepatient has a
pruritic eczematous dermatitis with erosions caused...
... of skin lesions formed from coalescing rings or
incomplete rings.
Pruritus: A sensation that elicits the desire to scratch. Pruritus is often the
predominant symptom of inflammatory skin diseases ... thyroid disease, polycythemia
vera, and delusions of parasitosis.
Figure 52-3
Erosion: Loss of epidermis without an associated loss of dermis.
Ulcer: Loss of epidermis and at least a portion of ...
Table 52-3 Common Dermatologic Terms
A schematic representation of several common primary skin lesions
(see Table 52-1).
Chapter 052. ApproachtothePatient
with a Skin Disorder
(Part...
... lesions often correlates highly with diagnosis (Fig. 52-6).
For example, a hospitalized patientwith a generalized erythematous exanthem is
more likely to have a drug eruption than is a patientwith ... a patientwith a similar rash limited to
the sun-exposed portions ofthe face. Once the distribution ofthe lesions has been
established, the nature ofthe primary lesion must be determined. ... lesions, the shape of individual lesions, and the arrangement ofthe
lesions.
An ideal skin examination includes evaluation ofthe skin, hair, and nails as
well as the mucous membranes ofthe mouth,...
... papulosquamous skin disease is characterized by small and
large erythematous papules and plaques with overlying adherent silvery scale.
Figure 52-8
Chapter 052. ApproachtothePatient
with a Skin...
... lesions with a
generalized arrangement are common and suggest a systemic etiology.
Figure 52-9
Erythema multiforme.
This eruption is characterized by multiple erythematous plaques with ... represents a hypersensitivity reaction to drugs
(e.g., sulfonylamides) or infections (e.g., HSV). (Courtesy ofthe Yale Resident's
Slide Collection; with permission.)
Figure 52-10
...
... against the surface ofthe
skin and rotated with downward pressure until it penetrates tothe subcutaneous
tissue. The circular biopsy is then lifted with forceps, and the bottom is cut with
iris ... previous illnesses
6. History of allergies
7. Presence of photosensitivity
8. Review of systems
9. Family history (particularly relevant for patients with melanoma,
atopy, psoriasis, or acne) ... suspected. The edge of such a lesion is scraped
gently with a no. 15 scalpel blade, and the removed scale is collected on a glass
microscope slide then treated with 1 to 2 drops of a solution of 10–20%...
... may also aid in the demonstration of tinea versicolor and
in recognition of ash leaf spots in patients with tuberous sclerosis.
Figure 52-12
Diascopy is designed to assess whether a skin lesion ...
noting the amount of blanching that occurs. Granulomas often have an opaque to
transparent, brown-pink "apple jelly" appearance on diascopy.
Figure 52-11
Chapter 052. Approachtothe ... or crusted
lesion, is unroofed, and the base ofthe lesion is scraped gently with a scalpel
blade. The material is placed on a glass slide, air-dried, and stained with Giemsa
or Wright's...
... Approachtothe
Patient with Cancer
(Part 1)
Harrison's Internal Medicine > Chapter 77. ApproachtothePatientwith
Cancer
Approach tothePatientwith Cancer: Introduction
The ... of current treatment techniques (surgery, radiation therapy,
chemotherapy, and biological therapy) results in the cure of nearly two of three
patients diagnosed with cancer. Nevertheless, patients ... cancer patients.
The 5-year survival for white patients was 39% in 1960–1963 and 68% in 1996–
same as the prognosis ofthe person with aortic stenosis who develops the first
symptoms of congestive...