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Contents

        Editorial

        287 Peer Review: The Best of the Blemished?
        Joseph S. Alpert

        Reviews

        289 Judicious Antibiotic Use and Intranasal Corticosteroids in Acute Rhinosinusitis
        Catherine Butkus Small, Claus Bachert, Valerie J. Lund, Augustine Moscatello, Anjuli S. Nayak, and William E. Berger
        Even though many cases are secondary to viral infections, acute rhinosinusitis is often treated with antibiotics. Recent studies have documented that inhaled corticosteroids in combination with antibiotics or as monotherapy provide significant symptom relief and resolution of acute rhinosinusitis.
        295 Guideline for Low-Cost Antimicrobial Use in the Outpatient Setting
        Lizbeth A. Hansen, Lee C. Vermeulen, Sarah Bland, and Tosha B. Wetterneck
        The authors have created a guideline for the use of less expensive but efficacious antibiotics in the management of common infections.
        303 Contemporary Empyema Necessitatis
        Scott A. Kono and Trenton D. Nauser
        Empyema infection may extend beyond the pleural space and into the chest wall. Early diagnosis, combined with effective antimicrobial therapy as well as early surgical drainage can result in marked improvement in prognosis for these patients.

        Update in Office Management

        306 Office Management of Chronic Pain in the Elderly
        Debra K. Weiner

        Diagnostic Dilemmas

        316 Too Much of a Good Thing
        Lisa Call Pastel and Jonathan M. Ross
        319 A Case for Vaccination
        Aima Ahonkai and Noah Lechtzin

        Images in Dermatology

        322 Mystery of the Silk Road
        John Patrick Welsh, Christopher B. Skvarka, Christine Ko, and Carrie Ann Cusack

        ECG Image of the Month

        325 A Racing Heart
        Julia H. Indik

        Images in Radiology

        328 A Complication of Forceful Nose-Blowing
        Amy Fix and Valerie J. Lang