December 2008 11 12 Issue of Clinical Advisor

Newsline

Kidney marker warns of heart disease risk

A new meta-analysis confirms "a strong and continuous association between proteinuria and subsequent risk of coronary heart disease."

Limit colorectal screening in the elderly?

The U.S. Preventive Services Task Force (USPSTF) is calling for an end to colorectal cancer (CRC) screening for persons older than 85 years and is ...

Aspirin and first heart attacks in diabetics

A large study has shown that aspirin and antioxidant supplements are ineffective in the primary prevention of heart attacks in people with diabetes and asymptomatic ...

A rash for the 21st century

Puzzled by a rash on a patient's face? Maybe she's allergic to the nickel in her cell phone.

Low-protein diets questioned

Low-protein diets do not appear to significantly improve renal function in people with type 1 or type 2 diabetic nephropathy.

Kids should now get double the vitamin D

The American Academy of Pediatrics has updated its vitamin D recommendations for infants, children, and adolescents, now calling for 400 IU per day beginning in ...

Smoking propels aneurysm risk in women

Smoking raises the risk of abdominal aortic aneurysm events nearly ninefold in postmenopausal women and negatively affects cognition in middle-aged adults

Snoring deemed risk factor for atherosclerosis

Researchers have isolated heavy snoring as an independent risk factor for carotid atherosclerosis

Drug Updates from MPR

Recombinant factor VIII for hemophilia A

Advisor Forum

Vitamin supplementation with diabetes

Combo therapy for pneumonia?

Stopping meds post atrial fibrillation flutter

Help for a migraine sufferer

Standard of care for MRSA infections

Shortness of breath on a statin

Glaucoma therapy in a blind patient

Preventing rabies

HRT after bilateral mastectomy

Is Bowen testing good for Lyme disease?

CRP vs. LDL as a stroke predictor

Alpha blockers for hyperhidrosis

If your patient hears sticks, look for ticks

Cover Feature

What you can learn from RBC analysis

Most anemia is diagnosed from screening a complete blood count (CBC). A prediction rule using the CBC and serum ferritin can help identify the type.

Clinical Feature

Difficult-to-treat chronic pain syndromes

Learn which pain complaints call for medication management only and which are more time-intensive and require multimodal regimens.

Advocating what works for diabetes

The most recent version of the ADA's clinical guidelines recommends a practical approach, backing treatments that have demonstrated benefit.

Dermatologic Look-Alikes

Bluish-purple facial papules

Two patients with bluish-purple facial papules—one on the nose and the other on the lower lip

Clinical Challenge

Rising home BP measurements in a hypertensive woman

Our patient's hypertension had been under moderate control for two decades. What was causing her BP to rise now?

Commentary

Noncompetes are nonproductive

Noncompete clauses harm our patients and the public.

Alternative Meds Update

Flaxseed

High in essential fatty acids, flaxseed—as well as meal and oil derived from it—are touted as effective agents to lower LDL and reduce cardiovascular (CV) ...

Dermatology Clinic

Rapidly enlarging conical lesion on the plantar surface

A 30-year-old man had a markedly hyperkeratotic conical lesion on his sole between the first and second metatarsals.

Annular purpuric rash on the lower extremities

A 47-year-old man had a three-month history of intermittent rash on the lower legs. The rash consisted of symmetric ringlike coalescing purpuric patches in a ...

Evidence-Based Medicine

Methylnaltrexone may relieve opioid-induced constipation

Compared with placebo, methylnaltrexone yielded a higher rate of bowel movement without laxative within four hours of first dose, within four hours after two or ...

Inhaled anticholinergics associated with increased risk of mortality and MI in COPD patients

Compared with control, anticholinergics were associated with higher rates of cardiovascular death in analysis of 12 trials with 12,376 patients, MI in analysis of 11 ...

New AAP recommendations for childhood lipid screening

The American Academy of Pediatrics has released a clinical report on lipid screening and cardiovascular health in childhood, which replaces the 1998 policy statement on ...

Arthroscopic surgery may not be beneficial for moderate-to-severe knee osteoarthritis

For moderate-to-severe secondary or idiopathic knee osteoarthritis, the addition of arthroscopic surgery appears no more effective than optimized physical and medical therapy alone.