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August 2008 11 8 Issue of Clinical Advisor

Newsline

The downside of too-tight glucose control

Findings from three recent studies call into question diabetes treatment strategies promoting very tight glucose control for the prevention of complications. Investigators for the Action ...

Deadline nears for inhaler switch

Time is running out for patients who use albuterol inhalers to replace those propelled by chlorofluorocarbons (CFCs) with ones that rely on eco-friendly hydrofluoroalkane (HFA). ...

Weak-heel test may ID best candidates for osteoporosis screens

Low bone strength of the heel as measured by a portable and relatively inexpensive ultrasound test could help pinpoint women who need...

Fish and fish oil appear to reduce AMD risk

A diet rich in omega-3 fatty acids and fish may keep age-related...

Diet diaries double weight loss

People who kept a written record of everything they ate lost more than twice as much weight as those who kept no records, say Kaiser ...

Drug Updates from MPR

Ibudone 5/200- Short-term acute pain treatment combo

Drug Updates from MPR: Short-term acute pain treatment combo

Short-term acute pain treatment combo

Advisor Forum

Parkinson's drugs still effective after treating restless legs?

We treat restless legs syndrome with Parkinson's drugs, such as pramipexole (Mirapex). Will these...

RECALCITRANT PLANTAR WARTS

For the past six months I have been treating plantar warts on the foot of a 20-year-old woman. After two Histofreeze treatments, the warts appeared...

Treating polycystic ovary syndrome

What is the best way to treat polycystic ovary syndrome (PCOS)?

BE WARY OF BETA-AGONISTS IN CHF PATIENTS

We seem to use beta-agonists for everything that wheezes these days. While these agents are technically for asthma, we routinely use...

Cholesterol goals in diabetes patients

Now that colesevelam (WelChol), a bile acid sequestrant (BAS), has been shown to decrease hemoglobin A1c (HbA1c), should it be the agent of...

SUSPECTED SPOUSAL ABUSE

If a woman relates a history that makes you highly suspicious of spousal abuse, are you obligated to report this to the authorities? What if ...

Can ACE inhibitor diagnose heart failure?

PROCALCITONIN IN PNEUMONIA THERAPY?

What is the significance of a procalcitonin (PCT) level in the face of questionable pneumonia? How reliable is a PCT determination in the decision to...

Race-specific hypertension treatment

An obese 48-year-old African American woman was sent from the emergency department for follow-up of newly diagnosed asymptomatic hypertension (BP 226/130 mm Hg). She was ...

Creatinine levels in the elderly

Some elderly patients show gradual increases in creatinine even when hypertension, blood glucose levels, etc., are well controlled. When should these patients be...

Difficult-to-assess blood findings

For the past several years, on a consistent basis, an asymptomatic 70-year-old Asian American man has had the following hematologic findings (with lab ranges) indicative ...

When to start low HDL treatment

What is the current recommendation for treating isolated low HDL levels? My patient is a 37-year-old white nonsmoker, whose original total cholesterol was...

WHICH ANTIHISTAMINES HALT ITCHING?

Which antihistamine is most likely to be effective in the treatment of pruritic lesions—loratadine (Claritin), fexofenadine (Allegra), fexofenadine with pseudoephedrine...

Potassium citrate for osteoporosis?

Can potassium citrate be used to treat osteoporosis?

STARTING STATINS WHEN LIVER ENZYMES ARE ELEVATED

I have many patients for whom statin therapy is indicated, but I am hesitant to start because of...

Pap and high-risk HPV

When the taste buds start to go

Fabric softener for louse nits

Clinical Feature

Keep low back pain patients out of surgery

Education, self-management, and pharmacologic as well as nonpharmacologic therapies take center stage in this latest, jointly issued guideline.

Recognizing symptoms of an enlarged prostate

The prostate gland has two important functions: To produce ejaculatory fluid and to act as a barrier to retrograde UTIs. Prostate enlargement, or benign prostatic ...

What to do when the "eyes" have it

Subconjunctival hemorrhage—widely referred to as "red eye"—is the most common ocular problem seen by primary-care clinicians. Red eye refers to hyperemia of the superficially visible...

Clinical Challenge

Anemia in a patient previously treated for renal insufficiency

Two months after moving to the United States from Egypt, 67-year-old Mr. A presented to the emergency department with moderate shortness of breath that worsened ...

A gastric bypass patient with recurrent bronchitis

Mrs. H, a 55-year-old Caucasian, presented as a new patient transfer with symptoms of uncomplicated acute bronchitis. She described five other similar illnesses over the ...

Alternative Meds Update

SAMe

Neither a drug nor an herb, SAMe—also known as SAM-e and SAME—is a synthetic version of a naturally occurring coenzyme.

Stat Consult

Cat-scratch disease

Self-limiting infection with Bartonella henselae, typically presents as tender lymphadenopathy about two weeks after...

Legal Advisor

Symptoms, diagnosis don't match

Mr. R, age 54, was a diabetic, moderately overweight construction worker. One day he tripped at a job site, falling heavily on his right hip. ...

Will going bare mean going broke?

After practicing internal medicine for 25 years, Dr. B began preparing for retirement. He cut back his hours and transferred many of his assets to ...