you'd want somebody who had a knowledge base that was important for the task.

Second thing, you'd want somebody that could maneuver effectively in conversation. So another word for an ambassador is a diplomat.

And so all three things are really necessary for a good ambassador, knowledge, wisdom is what we call the second thing, kind of a right use of knowledge, maneuvering, tactical wisdom. Probably we'll talk about that more in a little bit. And character.

Cardiomyopathy can be separated into primary (genetic, mixed, or acquired) and secondary categories, which result in varied phenotypes including dilated, hypertrophic, and restrictive patterns.

Severe valvular disease — In patients with a history of ARF who have developed severe, symptomatic valvular disease (ie, mitral stenosis, aortic stenosis, aortic insufficiency), New York Heart Association class III or IV heart failure, or ventricular dysfunction (ie, ejection fraction <50 percent), we recommend prophylaxis with an oral antibiotic rather than IM penicillin G benzathine (table 3).

Appendectomy for early appendicitis remains the treatment of choice for most children diagnosed with appendicitis (see 'Appendectomy' above).

NOM may be appropriate in selected children and according to patient and caregiver preference [35,36].

or older children who can better describe their symptoms (over six years of age) and meet all of the following criteria [35]:

Diuretics lessen the severity of obstructive sleep apnea and reduce blood pressure.

The only proven therapy for pulmonary hypertension related to COPD is supplemental oxygen. Supplemental oxygen should be recommended when the PaO2 is <60 mm Hg, because it has been shown to improve mortality by lowering pulmonary arterial pressures. Treatments effective for pulmonary artery hypertension should not be used.

Most orally administered immediate-release opioids such as morphine, oxycodone, and hydromorphone reach their peak effect at about 1 hour, at which time additional medication can be given if the patient is still in pain. Intravenous opioids reach their peak effect at about 10 minutes and intramuscular and subcutaneous opioids at about 20–30 minutes

Hypertonic osmotic laxatives such as milk of magnesia, magnesium citrate, and sodium phosphate draw water into the bowel and should be used with caution in older adults and those with renal impairment because of the risk of electrolyte abnormalities and dehydration in patients with irritable bowel syndrome (IBS). Lactulose, also an osmotic laxative, should be avoided in patients with IBS because it is broken down by colonic flora and produces excessive gas. Polyethylene glycol, a long-chain polymer of ethylene oxide, is a large molecule that causes water to be retained in the colon, which softens the stool and increases the number of bowel movements.

Symptoms should resolve within a few weeks, and referral for allergy testing can be considered if they are not resolved within 2 months. CT of the sinuses can be considered as well, but sinus radiographs are more specific

Other common causes of chronic cough include asthma, nonasthmatic eosinophilic bronchitis, and GERD. If asthma is suspected, spirometry is indicated. If spirometry is positive for asthma, a trial of an inhaled bronchodilator is indicated. If there are other indications of GERD such as heartburn, globus sensation, or hoarseness, an antacid or a trial of a proton pump inhibitor is indicated.

Key Points for Practice• Consider repeating urinalysis in women found to have microscopic hematuria associated with UTI following successful treatment.• With microscopic hematuria in patients at low risk of cancer, performing repeat urinalysis at six months is a reasonable alternative to imaging and cystoscopy.• Although gross hematuria is strongly associated with malignancy, microscopic hematuria is more common and has a lower malignancy risk.From the AFP Editors

Common causes include urinary tract infections (UTIs), menstruation, external genital lesions, vaginal atrophy, pelvic organ prolapse, urolithiasis, benign prostatic enlargement, and urethral stricture.