Laboratory evaluation

A. Imaging. Plain films are usually unnecessary for evaluating acute sinusitis because of the high cost and relative insensitivity.

B. CT scanning is useful if the diagnosis remains uncertain or if orbital or intracranial complications are suspected. CT scanning is nonspecific and may demonstrate sinus abnormalities in 87% of patients with colds.

C. MRI is useful when fungal infections or tumors are seriously considered.

D. Sinus aspiration is an invasive procedure, and is only indicated for complicated sinusitis, immunocompromise, failure to respond to multiple courses of empiric antibiotic therapy, or severe symptoms.

E. Cultures of nasal secretions correlate poorly with results of sinus aspiration.

Breaking Bulimia

Breaking Bulimia

We have all been there: turning to the refrigerator if feeling lonely or bored or indulging in seconds or thirds if strained. But if you suffer from bulimia, the from time to time urge to overeat is more like an obsession.

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