Heparin-induced thrombocytopenia is an uncommon manifestation of a very commonly used drug. It can lead to catastrophic complications, especially if appropriate therapy is not initiated. This article reviews the pathophysiology, diagnosis, and management of this important topic.

Antiplatelet therapy has an essential role in the treatment of cardiovascular disease. In this article, we discuss the characteristics of current, new and emerging antiplatelet drugs, their mechanisms of action, and their role in the primary and secondary prevention of cardiovascular disease.

It is often assumed that cardiovascular disease is due to issues related to lifestyle. While lifestyle does contribute to the expression of cardiovascular issues, a genetic etiology to Marfan's syndrome, hypertrophic cardiomyopathy and long QT syndrome have been shown. It is unclear as to what role genetics plays in hypertension and hyperlipidemia, although it is felt that genetics contributes to these pathologies as well.

A 36-year-old HIV-infected man admitted with a possible pyelonephritis of the left kidney and a 3.5 cm thrombus of the left renal vein developed sudden onset of dyspnea. Multiple cavitating nodules revealed under CT were aspirated yielding purulent fluid. MRSA isolates, from both the lung and blood had identical susceptibility patterns. The patient failed to respond to antibiotics until intravenous heparin was begun.

Hyperuricemia is an elevated uric acid level in blood. Gout is a common systemic metabolic disease characterized by deposition of monosodium urate monohydrate crystals with resultant acute intense inflammation of the involved joint. The clinical spectrum ranges from asymptomatic hyperuricemia to intermittent acute episodes of gouty arthritis to chronic tophaceous gout and chronic gouty arthropathy.

Erythropoietin refractory anemias represent a continuing and increasing burden on the healthcare system. The current practice of providing these patients with rHuEPO does not seem to be working. Fewer than 50% of patients respond in some studies. We demonstrate that androgens have multiple benefits in this population. They control anemia and stop transfusion dependence and improve nutritional parameters. In some patients, they also have a salutary effect on both white blood cell and platelet counts.

Tracheopathia osteochondroplasia is a rare slowly progressive benign disease of unknown etiology characterized by submucosal nodules protruding in the airway. Most patients are asymptomatic but with progression of disease, symptoms of cough, hemoptysis, dyspnea, wheezing, hoarseness, and rarely airway compromise have been reported. Management is symptomatic with control of cough, prophylaxis with antibiotics, and rarely surgery.

AASV is an autoimmune disease with multiple-system involvement, which if untreated, carries a poor prognosis. The kidneys are the most common involved organ in these vasculitides. We present a case of AASV who presented with severe anemia and acute renal failure that was treated with steroids and cyclophosphamide.

Direct-current cardioversion has a higher success rate than does medical therapy in converting supraventricular tachyarrhythmias to sinus rhythm and should be performed immediately in patients with hemodynamic instability. Hemodynamically stable patients with atrial fibrillation or atrial flutter, a rapid ventricular rate and without preexcitation syndrome should be treated with intravenous beta-adrenergic blocking drugs, amiodarone, verapamil, or diltiazem. In hemodynamically unstable patients with supraventricular tachycardia, intravenous adenosine is the drug of choice.

Hypersensitivity pneumonitis consists of a group of diseases resulting from inhalation of organic particles causing an immunopathological reaction of the lungs in susceptible individuals. The diagnosis requires a detailed and careful history that would include social, environmental, and occupational status, pulmonary function tests, serum precipitins, bronchoalveolar lavage, imaging, and lung biopsy. Early recognition and avoidance of the causative agent is important although the use of corticosteroids hastens improvement of symptoms.

Cardiac troponin is the biomarker of choice for the serological diagnosis of acute myocardial infarction. With the development of "highly sensitive" troponin assays, it is now possible to measure levels of this marker at and below the current 99th percentile of a healthy population; high sensitive troponin assays show great potential in earlier detection of acute myocardial infarction and better risk prediction in patients with acute coronary syndrome.

Eosinophilic esophagitis (EoE) is a chronic allergic inflammatory disease of the esophagus characterized by abnormal infiltration of eosinophils. The incidence of the disease that occurs in children and adults has been rapidly increasing in the last decade. Diagnosis and management of EoE warrants consultation with an allergist and a gastroenterologist.

The earliest diagnosis of diabetes is a mandate to arrest the worldwide epidemic of diabetes. The insulin assay with the oral glucose tolerance provides the earliest diagnosis. The pathology of diabetes occurs in those with normal blood sugars. With earliest diagnosis, the 'diabetes epidemic' can be arrested and then reversed.

Recognizing the focal role of the CNS and stress in the pathogenesis of chronic facial dermatitis, the author hypothesized that the main responsibility for the persistence of CFD lies in the parasympathetic portion of the CNS. The validity of this hypothesis is challenged with organ specific treatments, leading to the resolution of parasympathetic stress and CFD.