April 2005

Overactive bladder is a common, debilitating condition. Patients often feel uncomfortable or unwilling to mention the symptoms, and physicians should ask relevant questions to elicit the history of patients at risk. The most important part of the evaluation is the medical history, which is used to identify any of the numerous conditions that can cause overactive bladder or contribute to the symptoms. Anticholinergic medications are the cornerstone of therapy, with the newer, extended-release formulations generally having fewer side effects. Behavioral therapy to modify abnormal voiding patterns is a valuable therapeutic adjunct.

Angioedema is a hypersensitivity disorder that presents as edema of the subcutaneous tissues and mucosa, typically involving the upper airways or gastrointestinal tract, and often accompanied by urticaria. Although this condition could be either hereditary or acquired, the causes often overlap, with similar clinical manifestations. Diagnosis requires laboratory testing to determine serum complement levels. Treatment must be directed toward the resolution of the acute symptoms and prevention of recurrence.

Suicide is often viewed as "a permanent fix to a temporary problem." Unfortunately, for many individuals, attempting suicide is the answer. Estimates suggest there are from 8 to 25 suicide attempts for every one completion. As more lethal methods are used, the number of completed suicides increases. Physicians often see patients in the month before completion of the act. To provide effective treatment, they must be aware of the risks, particularly the red flags that indicate imminent risk in their patients.