Identifying obstructive sleep apnea

Identifying obstructive sleep apnea


Airflow disturbances during sleep need to be recognized and evaluated before harm comes to the patients themselves or those around them.

The case for vegetarianism in the fight against heart disease

The case for vegetarianism in the fight against heart disease

Multiple studies show that just about any low-meat or no-meat diet reduces almost all controllable risk factors for cardiovascular disease.

Epistaxis: the common and not-so-common nosebleed

Epistaxis: the common and not-so-common nosebleed

Approximately 90% of epistaxis cases seen can be treated successfully by primary-care providers. The remainder of cases require an otolaryngologist referral.

The two most common forms of skin cancer

The two most common forms of skin cancer

The start of the "sun-worshipping season" is a good time to review the primary-care basics of basal cell and squamous cell carcinomas.

What to know about home genetic-test kits

What to know about home genetic-test kits

Consumers becoming more involved in do-it-yourself genetic testing need primary-care clinicians to put the results into context for them.

Save a life with early detection of melanoma

Save a life with early detection of melanoma

Brush up on the basics of preventing, recognizing and addressing melanoma among your patient ranks.

Prostate cancer data, dilemmas and decisions

Prostate cancer data, dilemmas and decisions

Prostate cancer is the most common male-related malignancy in the US, the second most common cause of cancer-related death among men.

Solving the mystery 
of rheumatic disease

Solving the mystery 
of rheumatic disease

Selecting appropriate lab tests when evaluating persons with symptoms suggesting a rheumatic condition often requires a bit of detective work.

Diagnosing diseases
 of the vulva

Diagnosing diseases
 of the vulva

Vulvar biopsy is a helpful tool that should be utilized to diagnose 
and to guide the management of vulvar abnormalities.

A better understanding of barefoot running

A better understanding of barefoot running

Research on the relationship between footwear and injury rates is limited. A switch to a minimalist shoe or barefoot running should be done gradually.

The facts and fictions of chelation therapy

The facts and fictions of chelation therapy

Originally used to treat lead poisoning and hypercalcemia, chelation has shown promise among individuals with heart disease and other conditions.

What's the lifespan of mononucleosis?

What's the lifespan of mononucleosis?

A short review of the human herpesvirus mononucleosis, testing options and recurrence.

Treating ­hypertension in older patients

Treating ­hypertension in older patients

In those older than age 65 years, high BP heightens risk for various forms of heart disease as well as for chronic kidney disease and diabetes mellitus.

What you should know about medical marijuana

What you should know about medical marijuana

Federal criminalization of this drug—most commonly used in the treatment
of HIV, pain and glaucoma—has limited research into its effectiveness.

What's new with EHRs?

What's new with EHRs?

Advances are outpacing arrival speed for this potentially lifesaving technology.

Critics question DSM-5 methodology, transparency

Critics question DSM-5 methodology, transparency

Widespread over-diagnosis of certain conditions with new criteria among top concerns.

Understanding the 
changes in DSM-5

Understanding the 
changes in DSM-5

The latest revision of the diagnostic manual does away with the complex 
multiaxial organization in favor of a simpler chapter order of disorders.

Gout management 
in patients with CKD

Gout management 
in patients with CKD

The most recent guidelines from the American College of Rheumatology
include pharmacologic and nonpharmacologic therapy for hyperuricemia.

The most common causes of hair loss among women

The most common causes of hair loss among women

When treating an adult female patient with the chief complaint of alopecia, 
the clinician should pay particular attention to the pattern of hair loss.

Options for pelvic congestion syndrome

Options for pelvic congestion syndrome

This challenging diagnosis presents as a dull, throbbing and achy pain in 
the vulvar region and may require referral to an interventional radiologist.

Traumatic brain injury in youth athletes

Traumatic brain injury in youth athletes

Accurate identification, assessment and evaluation of concussions will enable clinicians to determine when it is safe for young athletes to return to competition.

Early diagnosis of malignant melanoma

Early diagnosis of malignant melanoma

Surveillance on the part of primary-care clinicians is critical to the 
timely identification of cancerous lesions in at-risk individuals.

Improving the quality of geriatric cancer survivorship

Improving the quality of geriatric cancer survivorship

A collaborative approach to cancer treatment, incorporating the entire oncology team and the PCP, provides the best outcomes for quality patient care.

Avoiding costly ­diagnostic mistakes

Avoiding costly ­diagnostic mistakes

How should a clinician 
handle a difference of 
opinion with the attending physician on duty?

A case study of nocturnal enuresis

A case study of nocturnal enuresis

A healthy and thriving boy aged 8 years, has never been able to achieve complete nighttime dryness since being potty trained at age 3 years.

Simple treatment for pediatric bedwetting

Simple treatment for pediatric bedwetting

When treating a young patient for monosymptomatic enuresis, be sure to assess the physical, emotional, and developmental maturity of the child.

ADHD Medication Chart

ADHD Medication Chart

A chart of medications available to treat Attention Deficit Hyperactivity Disorder (ADHD).

Assessing ­peritonsillar abscesses

Assessing ­peritonsillar abscesses

This infection manifests as a collection of pus and is often a complication of tonsillitis that may require referral to a specialist or hospitalization.

Vaccinations to 
protect adolescents

Vaccinations to 
protect adolescents

Often at increased risk for disease transmission, many teens and preteens
 do not receive the recommended immunizations in a timely manner.

Vaginal bleeding in the early stages of pregnancy

Vaginal bleeding in the early stages of pregnancy

A number of potential causes of vaginal bleeding in early pregnancy must be considered when deciding what type of management is required.

Sexual risk behavior 
among older adults

Sexual risk behavior 
among older adults

Societal changes and pharmaceutical advances have led to a rise in sexual 
activity in this population, and clinicians must adapt to a new reality.

What is BPA and how harmful is it to kids?

What is BPA and how harmful is it to kids?

Primarily used in food and drink packaging, ingestion of bisphenol A has recently been linked to obesity, diabetes, and reproductive disorders.

Managing UTIs in women

Managing UTIs in women

Urinalysis and physical exam determine if the infection is complicated or uncomplicated, primary or recurrent and guide treatment strategy.

Are climate change and obesity linked?

Are climate change and obesity linked?

Mounting evidence suggests current food production, transport and land use may negatively impact both climate and obesity outcomes.

Treating the older adult with HIV

Treating the older adult with HIV

Clinicians need to be prepared for the unique challenges presented by the growing number of older patients with HIV.

Communicating Concerns About Nonspecific Changes on ECG

Communicating Concerns About Nonspecific Changes on ECG

Exercise caution when a patient presents with acute chest pain. The ability to explain the situation as clearly as possible is essential.

Vasomotor rhinitis and allergic conjunctivitis

Vasomotor rhinitis and allergic conjunctivitis

The ability to differentiate between the allergic and nonallergic form of these conditions is crucial when determining treatment.

Case Report: High-Dose Methylphenidate for Adult ADHD

Case Report: High-Dose Methylphenidate for Adult ADHD

Long-acting ADHD medications improve adherence and demonstrate efficacy similar to that of immediate-release dose formulations.

Postpartum depression in a primary-care setting

Postpartum depression in a primary-care setting

Experienced by up to one in five mothers, postpartum depression often goes untreated. Learn what risk factors to be alert for.

The effects of exercise on LDL

The effects of exercise on LDL

As LDL goals become more aggressive, therapeutic lifestyle changes are increasingly important in achieving recommended lipid levels.

mHealth apps may make chronic disease management easier

mHealth apps may make chronic disease management easier

mHealth apps can help empower patients and improve management of chronic diseases like asthma, diabetes and heart disease.

Osteoarthritis and 
Rheumatoid ­Arthritis 2012: Pathophysiology, Diagnosis, 
and Treatment

Osteoarthritis and 
Rheumatoid ­Arthritis 2012: Pathophysiology, Diagnosis, 
and Treatment

This article highlights the differences in the pathophysiology and diagnostic criteria for OA and RA, and also describes current and potentially new treatment options for these conditions.

Managing infants with bronchiolitis

Managing infants with bronchiolitis

The symptoms of this common lung infection usually dissipate after a week, but some cases can become severe and require hospitalization.

What to do with a positive hepatitis C test

What to do with a positive hepatitis C test

If the treatment goal of viral eradicatication cannot be met, strive to slow disease progression, lower risk of liver cancer, and improve quality of life.

Identifying and treating hypogonadism

Identifying and treating hypogonadism

Clinicians should check how well patients are responding to testosterone replacement therapy every three to four months during the first year.

ADHD & antisocial personality disorder: Minimizing the risks

ADHD & antisocial personality disorder: Minimizing the risks

Around 20% of pediatric patients with ADHD will develop antisocial personality disorder in adulthood.

Vitamin D deficiency: Beyond bone health

Vitamin D deficiency: Beyond bone health

Vitamin D promotes absorption of calcium in the intestine and maintains adequate serum phosphate and calcium concentrations.

Improving melanoma awareness in men

Improving melanoma awareness in men

Men typically seek treatment after melanoma has already progressed to later stages, accounting for higher mortally rates compared with women.

Minimize admissions for heart failure

Minimize admissions for heart failure

The need to educate patients and help them make difficult lifestyle changes requires clinicians to think differently and offer novel treatment approaches.

Mixing herbal and 
prescription meds

Mixing herbal and 
prescription meds

Patients often consider supplements and herbs harmless, but combining them with other drugs can have devastating consequences.

Dismiss a problem
 patient in 10 safe steps

Dismiss a problem
 patient in 10 safe steps

Most clinicians have dealt with a dissatisfied or noncompliant patient. 
But how do you end the relationship without putting yourself at risk?

Smartphone apps screen for melanoma

Smartphone apps screen for melanoma

Smart phones or tablets are being used to revolutionize clinical diagnosis and patient care, but they pose a number of risks and benefits.

Salary Survey 2012: How are you doing?

Salary Survey 2012: How are you doing?

Find out how your income compares with the more than 9,000 nurse practitioners and physician assistants who completed our 2012 salary survey.

Optimizing technology for diabetes care

Optimizing technology for diabetes care

Advancements in diabetes care abound, but busy practice schedules 
make staying current difficult.

The special challenge of chronic pain

The special challenge of chronic pain

Failure to properly treat patients suffering legitimate chronic pain syndromes can result in a compounding of prescription pain-medication abuse.

Pain management: Lessons from patients

Pain management: Lessons from patients

These women experienced debilitating pain episodes that challenged even the most knowledgeable clinicians. You can learn from their case histories.

Elder abuse: Primary care strategies for screening

Elder abuse: Primary care strategies for screening

The primary-care provider may be the only contact homebound elders have outside the abuse situation.

"Predisease": A concept whose time has come?

"Predisease": A concept whose time has come?

Treating patients before they develop a disease is tempting, but the old 
adage still applies: First, do no harm.

What causes a metallic taste and burning tongue?

What are the differential diagnoses for a woman aged 60 years with a metallic taste in her mouth and the sensation of a burning tongue?

Demystifying the liver and its diseases

Demystifying the liver and its diseases

An understanding of the liver and its functions will provide the tools to perform a basic workup of patients suspected of having hepatic disease.

Getting young patients to take their medicine

Getting young patients to take their medicine

The problem is challenging, but there are steps clinicians can take to eliminate barriers to medication adherence in children.

Update on pediatric diarrheal illnesses

Update on pediatric diarrheal illnesses

Since the introduction of the rotavirus vaccine, rotavirus-associated diarrhea has declined and clinicians must now worry about other diarrhea-causing organisms.

Making the right choice in hormone therapy

Making the right choice in hormone therapy

A young cancer survivor prompts consideration of best practice in prescribing estrogen replacement therapy for herself and for others.

Alleviating treatment-resistant depression

Alleviating treatment-resistant depression

Anywhere from 10% to 30% of individuals taking a single antidepressant face obstacles to successful treatment, including undiagnosed illness.

Updated information 
on MRSA infections

Updated information 
on MRSA infections

The number of hospital-acquired MRSA infections is down; however, 
community-acquired MRSA infections continue to rise.

Alternative therapy for gestational diabetes

Alternative therapy for gestational diabetes

Insulin is the only agent recommended to lower glucose levels in pregnant 
women, but a second-generation sulfonylurea may provide another option.

Evaluating heart risk in 
asymptomatic patients

Evaluating heart risk in 
asymptomatic patients

An evidence-based guideline is available to help primary-care clinicians lower the burden of coronary deaths in this adult population

Practice antibiotic stewardship to preserve benefits

Practice antibiotic stewardship to preserve benefits

Considered "magic bullets" when they first arrived on the scene, antibiotics must be used appropriately to protect their effectiveness.

Evaluating salivary gland tumors and diseases

Evaluating salivary gland tumors and diseases

When diagnosing, consider the location and duration of the lesion, patient age, underlying systemic disorders and clinical appearance.

Diagnosing new-onset diabetes in children and teens

Diagnosing new-onset diabetes in children and teens

Type 2 diabetes in this population is increasing, but type1 diabetes is more prevalent. The ability to differentiate between these conditions is crucial.

When to screen for prostate cancer

When to screen for prostate cancer

In an update of its 2001 guidelines, the American Cancer Society stresses the importance of sharing the screening decision with the patient.

An algorithm for managing breast pain

An algorithm for managing breast pain

Breast pain can be an frightening experience, but the primary-care provider can often allay the patient's fears and capably manage the condition.

Getting back in the game after ACL rupture

Getting back in the game after ACL rupture

A safe return to activity is the goal of any injured athlete. Knee injuries deserve special attention, particulary those involving ligament damage.

New strategies against obesity comorbidities

New strategies against obesity comorbidities

Obese adults are at risk for many serious health conditions, including diabetes, coronary heart disease, hypertension, stroke, obstructive sleep apnea (OSA), depression and liver disease.

Raising awareness of HIV drug interactions

Raising awareness of HIV drug interactions

Antiretroviral agents can cause alterations the liver enzymes that are responsible for metabolizing many common medications.

New atrial fibrillation guidelines simplify primary care treatment

New atrial fibrillation guidelines simplify primary care treatment

Atrial fibrillation (AF) affects an estimated 2.3 million Americans and is becoming more widespread as the population ages. Read about guideline changes that simplify treating AF in primary care.

Therapy for major depressive disorder

Therapy for major depressive disorder

Depression can be dealt with in the clinical setting if the practitioner is familiar with the latest drug treatments and psychotherapeutic options.

How to implement home BP monitoring

How to implement home BP monitoring

Measuring BP at home can provide invaluable data to ensure accurate diagnosis and treatment. Make sure patients follow the proper protocol.

When to treat or refer a burn-injured patient

When to treat or refer a burn-injured patient

Guidelines from the American Burn Association provide a reliable road map for the assessment and treatment of these challenging injuries

Treatment guidelines for Alzheimer-type dementia

Treatment guidelines for Alzheimer-type dementia

The most common dementia in the elderly, Alzheimer disease places tremendous physical and emotional strain on patient and caregiver alike.

Adult polycystic kidney disease management

Adult polycystic kidney disease management

One of the most common causes of chronic kidney failure, polycystic kidney disease is an inherited condition with no proven treatment.

Nutrition therapy for new diabetes patients

Nutrition therapy for new diabetes patients

The latest evidence-based dietary recommendations from the American Diabetes Association focus on disease prevention and treatment.

Navigating ethics in a health-care setting

Navigating ethics in a health-care setting

From birth control to end-of-life care, medicine is fraught with ethical concerns. A clear understanding of the nomenclature is essential.

Interventions to reduce CVD risk in adults

Interventions to reduce CVD risk in adults

Evidence-based recommendations pay particular attention to ethnic minority and socioeconomically disadvantaged populations.

All that wheezes is not pediatric asthma

All that wheezes is not pediatric asthma

Many upper- and lower-airway problems can cause wheeze and cough, and some conditions coexist with asthma. Here's how to pin down a diagnosis.

Salary Survey 2011: Are you being paid what you're worth?

Salary Survey 2011: Are you being paid what you're worth?

How much money do you make? It's the question everyone wants to know the answer to but is too polite to ask. So Clinical Advisor asked it for you. Find out how your salary stacks up against your peers'.

Stroke-prevention guidelines updated

Stroke-prevention guidelines updated

Approximately one in four strokes are recurrent events. The AHA/ASAupdate provides evidence-based recommendations to reduce stroke risk.

How many skin lesions can you identify?

How many skin lesions can you identify?

Accurate diagnosis of a dermatologic condition relies on the ability to properly describe and document the cutaneous manifestations.

The best therapies for bacterial rhinosinusitis

The best therapies for bacterial rhinosinusitis

Knowing when to prescribe antibiotics and what kind to give is crucial. Here are some guidelines for patients with mild-to-moderate infections.

Chlamydia: Diagnosing the hidden STD

Chlamydia: Diagnosing the hidden STD

Because most cases of this common bacterial infection are asymptomatic, regular screening of at-risk patients is key to early detection and treatment.

Managing type 2 diabetes with renal impairment

Managing type 2 diabetes with renal impairment

Early identification and treatment is essential to the prevention of chronic kidney disease, a common diabetes complication.

Crisis management of a personality disorder

Crisis management of a personality disorder

Resolving the immediate problem is the primary concern when treating an individual with borderline personality disorder in the midst of a crisis.

Use fracture risk to predict osteoporosis

Use fracture risk to predict osteoporosis

Be sure to consult guidelines from the National Osteoporosis Foundation for advice on optimizing calcium and vitamin D intake and reducing fall risk.

Early-stage breast cancer treatment

Early-stage breast cancer treatment

Given the complex nature of the disease, the ability to clearly explain the therapeutic options available to patients with breast cancer is invaluable.

Reversing vitamin D deficiency in infants

Reversing vitamin D deficiency in infants

With fortified formula being shunned in favor of breastfeeding, rickets is making a comeback. Supplementation is the surest means of prevention.

Peripheral artery disease in primary care

Peripheral artery disease in primary care

Early diagnosis of this common manifestation of atherosclerosis is critical. Risk factors include smoking, diabetes, hypertension, and obesity.

Erectile dysfunction after prostate cancer

Erectile dysfunction after prostate cancer

As a side effect of radical prostatectomy, the favored treatment for many, erectile dysfunction can affect a man's mental and physical quality of life.

MRSA infections not limited to hospitals

MRSA infections not limited to hospitals

The Infectious Diseases Society of America's first treatment guidelines on this topic focus on the management of community-acquired infections.

Psychostimulants effective for ADHD

Psychostimulants effective for ADHD

Primary-care based psychopharmacologic and psychosocial interventions can be used to manage this common childhood disorder.

Hormone therapy guidelines updated

Hormone therapy guidelines updated

Data support starting hormone therapy to treat menopause-related symptoms and/or reduce the risk of osteoporosis or fractures.

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