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Case Management: Unremitting Functional Constipation and Fecal Incontinence in Childhood
Contributing Author: R. Cartland Burns, MD Sep 2018

Constipation is common among children, accounting for an estimated three percent of all visits to pediatricians and up to 30 percent of visits to pediatric gastroenterologists. Functional or idiopathic constipation, defined as persistently difficult, infrequent, or seemingly incomplete defecation without evidence of a primary anatomic or biochemical cause and often associated with abdominal pain, comprises more than 95 percent of cases of constipation in healthy children aged one year and older. Read the full story & the medicine behind it.

CME Credit
Case Management: Obstructive Sleep Apnea in Adults
Contributing Author: Shalini Manchanda, MD Jan 2018

Obstructive Sleep Apnea, (OSA) is a common disorder characterized by repetitive collapse of the upper airway during sleep that results in hypoxemia, hypercapnia, increased sympathetic activation, and sleep fragmentation. Cardinal features of the disorder in adults include loud snoring, gasping, and choking during sleep; excessive daytime sleepiness; fatigue; poor concentration; and decreased quality of life. Read the full story & the medicine behind it.

Case Management: Idiopathic Pulmonary Fibrosis
Contributing Author: David Roe, MD Nov 2017

Idiopathic pulmonary fibrosis (IPF) is a chronic fibrosing interstitial pneumonia of unknown etiology characterized by the progressive loss of lung function. Its prevalence (14 to 42 cases per 100,000) increases with age, the majority of patients being males 55 to 80 years with a current or previous smoking history. While the clinical course is highly variable and unpredictable, IPF has a poor prognosis: median survival time after diagnosis is just two to five years. Read the full story & the medicine behind it.

Case Management: Triple-Negative Breast Cancer
Contributing Author: Kandice Ludwig, MD Sep 2017

Invasive/infiltrating ductal carcinoma (IDC) is the most common type of breast cancer, accounting for approximately 80 percent of all diagnoses and more than 144,000 new US cases annually. Triple-negative breast cancer (TNBC), a molecularly diverse subgroup defined by a lack of ER, PR, and Her-2/neu expression, comprises about 15 percent of all IDC cases. Black women are twice as likely to present with TNBC, as evidenced by a study evaluating 39,000 women. Read the full story & the medicine behind it.

Case Management: Cutaneous Melanoma of the Head and Neck
Contributing Author: Cecelia Schmalbach, MD, MSc Jun 2017

The incidence of melanoma in the United States continues to rise, with nearly 90,000 new cases projected for 2017, 25 percent of which will occur in people younger than 40 years. Melanoma accounts for just one percent of all skin cancer diagnoses but is the primary cause of skin cancer mortality, responsible for almost 10,000 US deaths annually. Although melanoma can arise de novo, approximately half of all cases develop from a preexisting pigmented lesion. Read the full story & the medicine behind it.