A high degree of clinical suspicion and vigilance is necessary for early diagnosis of soft tissue infections and their differentiation from non-infected ulcers. Diagnosis and assessment depend primarily on clinical history and physical examination, although radiographs, scans and laboratory tests may also provide useful clinical data. The ability to detect bone in the base of an ulcer with a blunt sterile probe may be particularly useful in assisting the recognition of osteomyelitis. Effective treatment is based on a comprehensive strategy of wound care, avoidance of weight bearing, optimal metabolic control, appropriate antibiotic use and, possibly, surgical intervention. SC.M. East Carolina University School of Medicine Greenville, North Carolina Nutrition assessment and counseling are integral components of preconception and prenatal care.
Some factors identify the pregnant woman with a nutrition risk.
Vitamin and mineral supplementation should be based on a dietary assessment. Common discomforts of pregnancy frequently can be managed with dietary modification and safe pharmacotherapeutics. The nonsedating antihistamines are frequently prescribed agents. Fexofenadine and loratadine appear to be the least likely nonsedating antihistamines to interact with other medications and to result in a life-threatening interaction. This article reviews the known drug-drug interactions involving nonsedating antihistamines and provides a basis from which the clinician can predict potential interactions.