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5101. Epididymal Tuberculosis (Treatment)

, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference Disclosure: Received salary from Medscape for employment. for: Medscape. Richard A Santucci, MD, FACS Specialist-in-Chief, Department of Urology, Detroit Medical Center; Chief of Urology, Detroit Receiving Hospital; Director, The Center for Urologic Reconstruction; Clinical Professor of Urology, Michigan State University College of Medicine Richard A Santucci (...) . Before starting medications, investigate regional drug-resistance data. The chemoprophylaxis protocol for unconfirmed clinical disease is isoniazid (INH) for 6 months (9 mo in patients who are positive for human immunodeficiency virus [HIV]), INH and rifampin for 3 months, or rifampin and pyrazinamide for 2 months. Previous Next: Complications of GUTB Complications of genitourinary tuberculosis (GUTB) include the following: Superinfection Abscess Sinus formation Renal hypertension Scarring of renal

2014 eMedicine.com

5102. Eosinophilic Fasciitis (Treatment)

; Editor-in-Chief, Medscape Drug Reference Disclosure: Received salary from Medscape for employment. for: Medscape. Lawrence H Brent, MD Associate Professor of Medicine, Sidney Kimmel Medical College of Thomas Jefferson University; Chair, Program Director, Department of Medicine, Division of Rheumatology, Albert Einstein Medical Center Lawrence H Brent, MD is a member of the following medical societies: , , , Disclosure: Stock ownership for: Johnson & Johnson. Chief Editor Herbert S Diamond, MD (...) of a number of agents for second-line therapy. No consensus exists on which agent is best for that purpose. Physical therapy should be initiated to improve joint mobility and to decrease contractures.Surgical release has been used in some cases to manage significant joint contractures. [ ] Dermatologists, rheumatologists, and surgeons (for the skin-muscle biopsy) are consulted most often for management of these cases. Next: Medical Care Initial therapy There is wide consensus that systemic corticosteroids

2014 eMedicine.com

5103. Epidermolysis Bullosa Acquisita (Treatment)

= processing > Epidermolysis Bullosa Acquisita Treatment & Management Updated: Mar 05, 2019 Author: Jacob Reinhart, MD; Chief Editor: Dirk M Elston, MD Share Email Print Feedback Close Sections Sections Epidermolysis Bullosa Acquisita Treatment Medical Care Patients with epidermolysis bullosa acquisita (EBA) may require therapy with oral corticosteroids, anti-inflammatory agents, and immunosuppressants. [ , , , , ] For patients who are on long-term systemic corticosteroid treatment, daily calcium, vitamin (...) of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic David F Butler, MD is a member of the following medical societies: , , , , Disclosure: Nothing to disclose. Edward F Chan, MD Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania School of Medicine Edward F Chan, MD is a member of the following medical societies: , , Disclosure: Nothing to disclose. Chief Editor Dirk M Elston, MD Professor and Chairman

2014 eMedicine.com

5104. Extracorporeal Photopheresis (Treatment)

Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA Richard P Vinson, MD is a member of the following medical societies: , , , Disclosure: Nothing to disclose. Amanda M M Oakley, MBChB, FRACP Adjunct Associate Professor, Department of Medicine, Waikato Clinical School; Dermatologist, Department of Dermatology, Waikato Hospital, New Zealand Amanda M M (...) Oakley, MBChB, FRACP is a member of the following medical societies: , American Dermatological Association, , , , Disclosure: Received income in an amount equal to or greater than $250 from: Indirectly as employee of DermNet New Zealand, from multiple sponsoring pharmaceutical companies
Received consulting fee from MoleMap NZ for consulting. Chief Editor William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University

2014 eMedicine.com

5105. Rubella (Treatment)

University College of Physicians and Surgeons; Private Practice, Sutton Place Dermatology, PC Peter C Lombardo, MD is a member of the following medical societies: , , , , Disclosure: Nothing to disclose. Specialty Editor Board Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA Richard P Vinson, MD is a member of the following medical societies (...) : , , , Disclosure: Nothing to disclose. Van Perry, MD Assistant Professor, Department of Medicine, Division of Dermatology, University of Texas School of Medicine at San Antonio Van Perry, MD is a member of the following medical societies: Disclosure: Nothing to disclose. Chief Editor Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine Dirk M Elston, MD is a member of the following medical societies: Disclosure

2014 eMedicine.com

5106. Rosacea (Treatment)

: Aug 14, 2018 Author: Agnieszka Kupiec Banasikowska, MD; Chief Editor: William D James, MD Share Email Print Feedback Close Sections Sections Rosacea Treatment Medical Care Before the initiation of therapy, the triggering factors that exacerbate the patient's rosacea should be identified and avoided if possible. These factors may be unique to each individual patient. Common triggering factors include hot or cold temperatures, wind, hot drinks, caffeine, exercise, spicy food, alcohol, emotions (...) , Georgetown Dermatology, PLLC Agnieszka Kupiec Banasikowska, MD is a member of the following medical societies: , Disclosure: Nothing to disclose. Coauthor(s) Saurabh Singh, MD Staff Physician, Department of Dermatology, Georgetown University/Washington Hospital Center Disclosure: Nothing to disclose. Specialty Editor Board Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference Disclosure: Received

2014 eMedicine.com

5107. Rickettsialpox (Treatment)

Mohammad J Alam, MD is a member of the following medical societies: , , , Disclosure: Nothing to disclose. Specialty Editor Board Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference Disclosure: Received salary from Medscape for employment. for: Medscape. Charles V Sanders, MD Edgar Hull Professor and Chairman, Department of Internal Medicine, Professor of Microbiology, Immunology (...) & Management Updated: Jun 30, 2017 Author: Pradeep Kumar Mada, MD, MRCP(UK); Chief Editor: Mark R Wallace, MD, FACP, FIDSA Share Email Print Feedback Close Sections Sections Rickettsialpox Treatment Medical Care Rickettsialpox is a self-limited disease; however, antibiotics hasten defervescence and provide relief of other systemic symptoms. A presumptive diagnosis of rickettsialpox can be made based on high clinical suspicion in the correct geographic context, and empiric antimicrobial therapy can

2014 eMedicine.com

5108. Rhinoviruses (Treatment)

years). In January 2008, the FDA completed its review of information regarding the safety of OTC cough and cold medicines in children younger than 2 years. This review resulted in a new recommendation that these drugs should not be used to treat children in this age group, because serious and potentially life-threatening adverse effects can occur. In October 2008, the pharmaceutical industry voluntarily changed the labeling for OTC pediatric cough and cold drugs to include that a statement (...) these drugs should not be used in children younger than 4 years. This action was in response to dosing errors, misuse, and overuse of OTC pediatric cough and cold medications. Each year, nearly 7000 visits to EDs in the United States by children younger than 11 years are associated with cough and cold medicines. Healthcare providers should emphasize to parents and caregivers that although OTC medications are available without a prescription, that does not mean that they are harmless. Providers should

2014 eMedicine.com

5109. Rhinocerebral Mucormycosis (Treatment)

medication, antimetabolites, or immunosuppressants that the patient is on should also be addressed and discontinued if appropriate. [ ] Granulocyte colony-stimulating factor (GCSF) can be administered to reconstitute host defenses and to enhance leukocytosis. [ ] Dexamethasone has been used to treat brain edema. Hyperbaric oxygen (HBO) therapy has been used in an attempt to control the infection. Experts suggest that HBO may exercise fungistatic activity by reducing tissue hypoxia and acidosis. However (...) College of Medicine Michael T Yen, MD is a member of the following medical societies: , Disclosure: Nothing to disclose. Natalie Ana Baugh California State University, Long Beach Disclosure: Nothing to disclose. Specialty Editor Board Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference Disclosure: Received salary from Medscape for employment. for: Medscape. Chief Editor Mark R Wallace, MD, FACP

2014 eMedicine.com

5110. Scorpion Sting (Treatment)

Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference Disclosure: Received salary from Medscape for employment. for: Medscape. Chief Editor Joe Alcock, MD, MS Associate Professor, Department of Emergency Medicine, University of New Mexico Health Sciences Center Joe Alcock, MD, MS is a member of the following medical societies: Disclosure: Nothing to disclose. Additional Contributors Lisa Kirkland, MD, FACP, FCCM, MSHA Assistant Professor, Department of Internal Medicine (...) >160: +2 Corticosteroid PTA: +2 Temperature >38ºC: +1 Heart rate >100 bpm: +1 Although grading and scoring systems have been developed, they are limited due to species specificity and low-degree symptoms that would lead to hospitalization or therapy. Previous Next: Medical Care Because the clinical manifestations and severity of the symptoms vary among patients, individualize management of scorpion stings. Furthermore, frequent patient monitoring allows earlier recognition of the life-threatening

2014 eMedicine.com

5111. Hyperosmolar Coma (Treatment)

. 2017 Mar 23. . Media Gallery Glucose metabolism chart of 1 Tables Contributor Information and Disclosures Author Dipa Avichal, DO Resident Physician, Department of Internal Medicine, Einstein Healthcare Network Dipa Avichal, DO is a member of the following medical societies: , Disclosure: Nothing to disclose. Coauthor(s) Nissa C Blocher, MD Attending Physician, Division of Endocrinology, Associate Program Director, Endocrinology Fellowship, Albert Einstein Medical Center Nissa C Blocher, MD (...) is a member of the following medical societies: , , , Disclosure: Nothing to disclose. Chief Editor George T Griffing, MD Professor Emeritus of Medicine, St Louis University School of Medicine George T Griffing, MD is a member of the following medical societies: , , , , , , , , , , Disclosure: Nothing to disclose. Additional Contributors Robin R Hemphill, MD, MPH Associate Professor, Director, Quality and Safety, Department of Emergency Medicine, Emory University School of Medicine Robin R Hemphill, MD

2014 eMedicine.com

5112. The Role of Antibiotics in Cutaneous Surgery (Treatment)

of the following medical societies: , , , Disclosure: Nothing to disclose. Specialty Editor Board David F Butler, MD Former Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic David F Butler, MD is a member of the following medical societies: , , , , Disclosure: Nothing to disclose. Chief Editor William D James, MD Paul R Gross Professor of Dermatology, Vice (...) -Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine William D James, MD is a member of the following medical societies: , Disclosure: Received income in an amount equal to or greater than $250 from: Elsevier; WebMD. Additional Contributors Desiree Ratner, MD Director, Comprehensive Skin Cancer Center, Continuum Cancer Centers of New York; Director of Dermatologic Surgery, Beth Israel Medical Center and St Luke's and Roosevelt Hospitals

2014 eMedicine.com

5113. Testicular Trauma (Treatment)

> Testicular Trauma Treatment & Management Updated: Jun 26, 2017 Author: Ryan P Terlecki, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS Share Email Print Feedback Close Sections Sections Testicular Trauma Treatment Medical Therapy Institute conservative treatment for patients with minor trauma in which the testes are unequivocally spared and the scrotum has not been violated. The usual treatment consists of the following: Scrotal support Nonsteroidal anti-inflammatory drugs Ice packs Bed rest for 24 (...) of Medicine Richard A Santucci, MD, FACS is a member of the following medical societies: , , Disclosure: Nothing to disclose. Specialty Editor Board Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference Disclosure: Received salary from Medscape for employment. for: Medscape. Shlomo Raz, MD Professor, Department of Surgery, Division of Urology, University of California, Los Angeles, David Geffen

2014 eMedicine.com

5114. Surgical Complications (Treatment)

medications known to affect hemostasis include warfarin, aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs), and antiplatelet agents. Warfarin inhibits the production of the vitamin K–dependent coagulation proteins II, VII, IX, and X to interfere with fibrin clot formation. The peak effects of warfarin anticoagulation are seen at 72-96 hours after administration and may be monitored by measurement of the international normalized ratio (INR) and prothrombin time. Aspirin irreversibly inhibits (...) that both the patient and the doctor agree on the area to be treated. Communicating and cross-referencing beforehand cannot be overemphasized. If a difference in opinion exists, it may be discussed at this time. Medical risk factors are identified during the initial patient encounter. An effective strategy is to combine the use of a questionnaire form, which may be reviewed by the physician, and direct questioning to clarify and confirm identified risks. See the image below. Preoperative evaluation

2014 eMedicine.com

5115. Q Fever (Overview)

, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference Disclosure: Medscape Salary Employment Jeter (Jay) Pritchard Taylor III, MD Compliance Officer, Attending Physician Emergency Medicine Residency, Department of Emergency Medicine, Palmetto Richland Memorial Hospital, University of South Carolina Jeter (Jay) Pritchard Taylor III, MD is a member of the following medical societies: , , , and Disclosure: Nothing to disclose. Mary L Windle, PharmD Adjunct (...) of Tennessee College of Medicine; Consulting Staff, Department of Internal Medicine, Division of Infectious Diseases, Methodist Healthcare of Memphis Kerry O Cleveland, MD is a member of the following medical societies: , , Disclosure: Nothing to disclose. Chief Editor Burke A Cunha, MD Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital Burke A Cunha, MD is a member of the following medical societies

2014 eMedicine.com

5116. Pyelonephritis, Acute (Overview)

due to potential effects on the musculoskeletal system Contributor Information and Disclosures Author Tibor Fulop, MD, PhD, FACP, FASN Professor of Medicine, Department of Medicine, Division of Nephrology, Medical University of South Carolina College of Medicine; Attending Physician; Medical Services, Ralph H Johnson VA Medical Center Tibor Fulop, MD, PhD, FACP, FASN is a member of the following medical societies: American Academy of Urgent Care Medicine, , , , , International Society (...) for Apheresis, International Society for Hemodialysis, Magyar Orvosi Kamara (Hungarian Chamber of Medicine), Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Fresenius Medical Care, Hungary; Dialysis Clinic Inc., USA. Specialty Editor Board Eleanor Lederer, MD, FASN Professor of Medicine, Chief, Nephrology Division, Director, Nephrology Training Program, Director, Metabolic Stone Clinic, Kidney Disease Program, University of Louisville School of Medicine

2014 eMedicine.com

5117. Psychosocial and Environmental Pregnancy Risks (Overview)

to be measurable in the fetal circulation compared to other chemicals. Recent studies indicate that more than 90% of pregnant women take medication during pregnancy, and many women take more than 4 different drugs during the course of pregnancy. The US Food and Drug Administration (FDA) requires animal testing before the approval of new medications. The FDA also uses a classification system to define fetal risks for all FDA-approved drugs. The pharmaceutical pregnancy risk classification by the FDA (...) . Importantly, keep in mind that the same parameters used when considering the teratogenicity of chemicals also apply to drugs. An important developmental window may exist during which an effect can occur. Organogenesis, which occurs during postconception weeks 2-8, is typically the most important window. To be considered causative, the drug must be able to access the fetus through the placenta or be able to interact with maternal systems to create the effect. Medications can alter the fetal environment

2014 eMedicine.com

5118. Pseudomembranous Colitis (Overview)

Professor, Department of Internal Medicine, Division of Gastroenterology, Baylor College of Medicine BS Anand, MD is a member of the following medical societies: , , , Disclosure: Nothing to disclose. Acknowledgements Acknowledgments The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, or the US government. LCDR Jennifer Curry is a military service member. This work was prepared (...) a possible association between the use of proton pump inhibitors (PPIs) and the development of Clostridium difficile –associated diarrhea (CDAD). [ ] Data were collected from the US Food and Drug Administration’s (FDA's) Adverse Event Reporting System (AERS) and the medical literature for cases of CDAD in patients undergoing treatment with PPIs. Many of the adverse event reports involved patients who were elderly, had chronic and/or concomitant underlying medical conditions, or were taking broad-spectrum

2014 eMedicine.com

5119. Proteus Infections (Overview)

. Proteus mirabilis bloodstream infections: risk factors and treatment outcome related to the expression of extended-spectrum beta-lactamases. Antimicrob Agents Chemother . 2005 Jul. 49(7):2598-605. . Engel JD, Schaeffer AJ. Evaluation of and antimicrobial therapy for recurrent urinary tract infections in women. Urol Clin North Am . 1998 Nov. 25(4):685-701, x. . Kaye D, Tunkel AR, Fournier GR. Stein, ed. Internal Medicine . 5th ed. St Louis, Mo: Mosby-Year Book; 1998. Li X, Lockatell CV, Johnson DE, et (...) bacteria. Courtesy of the CDC. of 1 Tables Contributor Information and Disclosures Author Gus Gonzalez, MD Medical Oncologist, The Center for Cancer and Blood Disorders Gus Gonzalez, MD is a member of the following medical societies: Disclosure: Nothing to disclose. Coauthor(s) Michael Stuart Bronze, MD David Ross Boyd Professor and Chairman, Department of Medicine, Stewart G Wolf Endowed Chair in Internal Medicine, Department of Medicine, University of Oklahoma Health Science Center; Master

2014 eMedicine.com

5120. Prostatitis, Bacterial (Overview)

of cystitis and prostatitis. Biofilm formation by bacteria allows the bacteria to persist despite antibiotic treatment. Biofilms are protective aggregates of bacteria that form in response to host defenses or antibiotic therapy; in prostatitis, they develop deep in the ducts of the prostate. [ ] Patients with organisms persisting in biofilms or within obstructed ducts may have persistent symptoms despite sterile cultures. Hemolysin may also increase the ability of bacteria to persist as biofilms, as seen (...) of a Prospective Pilot Double-Blind and Randomized Placebo-Controlled study. BJU Int . 2014 Oct 13. . Meares ET. Chronic bacterial prostatitis: role of transurethral prostatectomy (TURP) in therapy. Schmiedt E, Alken JE, Bauer HW. Therapy of prostatitis . Munich, Germany: Zuckerschwerdt Verlag; 1986. 193-197. Murphy AB, Macejko A, Taylor A, Nadler RB. Chronic prostatitis: management strategies. Drugs . 2009. 69(1):71-84. . Dennis LK, Lynch CF, Torner JC. Epidemiologic association between prostatitis

2014 eMedicine.com

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