Testicular conditions in athletes: torsion, tumors, and epididymitis.

Individuals involved in sports are at risk for sustaining various injuries. In addition to musculoskeletal complaints, male athletes are at risk of incurring testicular injuries. These issues can range from an acute emergency such as testicular torsion to indolent testicular tumors. In contrast, epididymitis can present in stages. Presentation and management of testicular complaints can vary depending on the condition. Physicians who provide medical care to athletes need to be competent in diagnosing and managing testicular injuries.

Evaluation of suspected dementia.

As the proportion of persons in the United States older than 65 years increases, the prevalence of dementia will increase as well. Risk factors for dementia include age, family history of dementia, apolipoprotein E4 genotype, cardiovascular comorbidities, chronic anticholinergic use, and lower educational level. Patient history, physical examination, functional assessment, cognitive testing, laboratory studies, and imaging studies are used to assess a patient with suspected dementia. A two-visit approach is time-effective for primary care physicians in a busy outpatient setting. During the first visit, the physician should administer a screening test such as the verbal fluency test, the Mini-Cognitive Assessment Instrument, or the Sweet 16. These tests have high sensitivity and specificity for detecting dementia, and can be completed in as little as 60 seconds. If the screening test result is abnormal or clinical suspicion of another disease is present, appropriate laboratory and imaging tests should be ordered, and the patient should return for additional cognitive testing. A second visit should include a Mini-Mental State Examination, Geriatric Depression Scale, and verbal fluency and clock drawing tests, if not previously completed.