Current Issue: Volume 21 - Number 5 - May 2013

Feature » Case Report

Functional Tremor Misdiagnosed as Parkinson’s Disease in a Geriatric Patient

Tremor is a common involuntary movement disorder that is associated with numerous neurological disorders and neurodegenerative diseases, including Parkinson’s disease (PD). In this case report, the authors describe an elderly woman who experienced a traumatic event and developed a tremor thereafter, which was misdiagnosed as PD. She was treated for 20 years with a regimen of carbidopa/levodopa before physicians discovered that she had a functional tremor, not PD. This case illustrates the importance of clinicians taking the time to distinguish the etiology of any tremors to ensure their patients are being treated appropriately.

Read the full article »

Feature » NSAIDs and the Elderly

NSAIDs and the Geriatric Patient: A Cautionary Tale

Nonsteroidal anti-inflammatory drugs (NSAIDs) are known to complicate many common medical problems, particularly among older adults. Some of the adverse effects reported with NSAIDs, many of which are commonly used, include an increased risk of reinfarction, gastrointestinal bleeding, atrial fibrillation, stroke, and cardiovascular death. This article provides a review of some of the most common severe complications caused by NSAIDs, with a focus on what has been reported with regard to the geriatric patient. 

Read the full article »

Feature » PhotoDx

Diagnosing a Questionable Rash in an Elderly Man

A 73-year-old man presented to our office for what he described as a “rash” on his right leg. The patient had reported that the problem disseminated and persisted on his right leg for approximately 3 weeks (Figure). At the time, the patient was experiencing dryness, irritation, itching, rash, and redness on the affected area. The patient said that he did not have any allergies. He had expressed symptoms of fatigue and low energy but noted no decrease in appetite. He had a history of chronic cough and hypertension. The mass was firm to palpation. He had no history of trauma to that area. He was not taking any medications. We performed a biopsy and asked the patient to return for a follow-up of the biopsy results.Hodgkin disease, B-cell lymphoma, Anaplastic large cell lymphoma, Metastatic carcinoma

Based on the case description and the photograph, what is your diagnosis?

A. Hodgkin disease

B. B-cell lymphoma

C. Anaplastic large cell lymphoma

D. Metastatic carcinoma

 

Read the full article »

Feature » Vitamins and Dietary Supplements

Vitamins and Dietary Supplements: Controversy and Confusion

Millions of Americans routinely consume dietary supplements, making it into a billion-dollar industry. However, despite their vast popularity among persons of all ages, there are conflicting data as to whether using these supplements is effective in the prevention of chronic illness or promotes overall health. This article synthesizes the current body of literature to identify the most significant evidence that supports and refutes the use of vitamins and dietary supplements.

Read the full article »