Deprescribing at the end of life in older patients.

In the United States, the adult population that will need hospice and palliative care is expected to double in the next 40 years. In primary care, providers are often faced with tough decisions on how to manage patients' medications at the end of life. This article describes how to deprescribe in the last year of life.

The Use of Medicinal Leeches for the Treatment of Venous Congestion in Replanted or Revascularized Digits.

Purpose: A noteworthy cause of failure in digital replantation is venous insufficiency. External bloodletting with medicinal leeches is a common treatment for venous insufficiency after distal digital replantations. The objective of this study was to evaluate the salvage rate of digits replanted proximal to the distal interphalangeal (DIP) joint that were treated with medicinal leeches for venous congestion.

Multiple sclerosis: a review of the disease and treatment options.

Objective: To provide a review of the etiology, epidemiology, clinical features, diagnostic findings, and treatment options for multiple sclerosis (MS).

Data Sources: A PubMed search of English language articles using a combination of words: elderly; multiple sclerosis*, late onset multiple sclerosis*, etiology; screening; diagnosis; or treatment to identify original studies, guidelines, and reviews on multiple sclerosis and late-onset multiple sclerosis, published 2002 to 2013. Primary sources were then used to search for additional relevant material.

Free myocutaneous flap transfer to treat congenital Volkmann's contracture of the forearm.

The purpose of this study is to report our experience with free functional muscle transfer procedures for the late sequelae of the rare condition of congenital Volkmann's ischaemic contracture of the forearm. Four children, with an average age of 9.5 years (range 1.

Systemic lupus erythematosus: a review of the disease and treatment options.

Objective: To provide an up-to-date review of the etiology, epidemiology, clinical features, diagnostic findings, and treatment options for systemic lupus erythematosus (SLE).

Data Sources: A PubMed search of English language articles using a combination of words: elderly, systemic lupus erythematosus*, late onset systemic lupus erythematosus*, etiology, screening, diagnosis, or treatment to identify original studies, guidelines, and reviews on systemic lupus erythematosus, SLE, and late onset systemic lupus erythematosus, published 2000 to present.

Study Selection And Data Extraction: Original studies, clinical reviews, references, and guidelines were obtained and evaluated on their clinical relevance.