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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: 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.

Case Management: Atrial Fibrillation
Contributing Author: Gopi Dandamudi, MD Mar 2017

AF is the most common sustained cardiac arrhythmia, affecting an estimated 2.7 to 6.1 million people in the United States, or approximately two percent of individuals <65 years and nine percent of those ≥65 years. Aside from increasing age and family history, hypertension is the greatest risk factor for AF, accounting for more than one-fifth of all cases. Read the full story & the medicine behind it.

Case Management: Endoscopic Diagnosis, Treatment, and Surveillance of Barrett's Esophagus
Contributing Authors: William Kessler, MD, Hala Fatima, MD Jan 2017

An estimated six percent of US adults have BE,1 a condition in which metaplastic columnar mucosa replaces the stratified esophageal squamous epithelium.2 Metaplasia is often a response to chronic inflammation, with GERD linked to a 10 to 15 percent risk. Other risk factors for BE include hiatal hernia, age >50 years, male gender, white race, cigarette smoking, family history, and central obesity. Read the full story & the medicine behind it.