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February 2009 12 2 Issue of Clinical Advisor

Newsline

Antibiotic benefits COPD patients

Macrolide therapy apparently reduces both the frequency and severity of exacerbations in patients with moderate-to-severe chronic pulmonary obstructive disease (COPD).

Kidney injury raises chances of ESRD

Kidney stones and acute kidney injuries caused by trauma, illness, or surgery may predispose patients to end-stage renal disease (ESRD), a pair of new cohort ...

Weekly goal of 2.5 active hours recommended

Adults gain substantial health benefits from at least 150 minutes per week of moderate-intensity physical activity and can accrue additional benefits as the intensity, frequency, ...

Unexplained decline in anemia is welcome

Researchers have detected a significant but unexplained decline in the prevalence of anemia among women and children.

Comorbidities slow MS diagnosis

Chronic conditions, such as obesity, diabetes, high BP, or high cholesterol, seem to delay multiple sclerosis (MS) diagnoses.

Could it really be leprosy?

157 new cases of leprosy (or Hansen's disease) were detected in 2007 nationwide.

Positive spin pushes cancer screenings

If you want to effectively encourage African American patients to be screened for colon cancer, accentuate the positive.

Hemoglobin target still stands for most diabetics

The American College of Cardiology (ACC), American Diabetes Association (ADA), and American Heart Association (AHA) issued a joint statement urging clinicians not to abandon the ...

Vitamin D levels falling, especially in men

According to the National Health and Nutrition Examination Surveys, vitamin D levels are falling among adult men.

Guidelines stress weight control

Losing weight and engaging in low-impact aerobic exercise are the top recommendations of new guidelines for symptomatic osteoarthritis of the knee.

Many older folks can improve walking problems

Older Americans who have difficulty walking may not have to suffer for long.

Drug Updates from MPR

Adjunctive treatment for severe epilepsy

Rufinamide is for patients with Lennox-Gastaut syndrome.

Advisor Forum

Leg swelling following hip replacement

Why does amlodipine lead to edema?

I am unable to find a valid explanation for the edema that develops with amlodipine. Is the cause vascular distension, vessel permeability, or renal hemodynamics? ...

Osteoporosis concerns in a premature infant

A 20-month-old girl born premature was diagnosed with necrotizing enterocolitis and underwent...

Nail pitting

Anxiety and cardiac disorders

I have read that anxiety can be an early symptom of cardiac disorders. What screening tests would help clinicians detect...

H. pylori in the stool vs. the blood

Both sides of the fever coin

Is there any validity to statements by patients that their basal temperature is always low and...

Disinfecting fungus-contaminated shoes

Is spraying with diluted bleach solution or placing the shoes in moth balls effective?

Switch cholesterol therapy?

Skin tag removal

What is the best way to minimize scarring in the removal of skin tags? I find that cryotherapy results in...

Who should have carotid ultrasound?

More and more offices are performing their own carotid ultrasounds. In light of recent guidelines published by...

Musculoskeletal effects of diabetes

A 48-year-old Caucasian woman diagnosed with type 1 diabetes at the age of 10 complains of stiffness in her wrists, elbows, knees, and ankles.

Avoiding lactic acidosis

How high can creatinine go before you must...

Is chemotherapy working?

A 67-year-old man with stage 3 non-small cell lung cancer has had two sessions of...

Injection diversion

Cover Feature

Treatment options for respiratory infections

Guidelines advise against the routine use of antibiotics, but patients demand them. Find out what alternatives are available and when to use them.

Clinical Feature

Colorectal cancer: Prevention vs. detection

When it comes to screening, primary-care clinicians are in a position to play a crucial role in helping patients choose the right test for them.

Specialists call for tighter BP control

New research underscores the urgency for obese children and patients with diabetes. But attaining a BP goal is not enough—maintenance is key.

Dermatologic Look-Alikes

Pink papules on the fingers

Two patients with pink-purple hand papules—but only one shows interface dermatitis and lymphocytic infiltrate.

Clinical Challenge

Elusive pulmonary symptoms prove difficult to pin down

After several hospital admissions for fatigue, dyspnea, and cough, bronchoscopy finally pointed to an accurate diagnosis.

Commentary

Reducing pharmacy "telephone tag"

I thought it might be useful to share some quick ways you can improve the safety and efficiency of your prescriptions and reduce pharmacy callbacks.

Alternative Meds Update

Feverfew

Feverfew is a medicinal herb that has largely been found safe and effective for migraine prophylaxis.

Dermatology Clinic

Asymptomatic netlike red-brown patch on the back

A52-year-old white man with no significant past medical history who presented to the dermatology clinic for evaluation of an asymptomatic reticulated red-brown patch that had ...