January 2016 Issue of Clinical Advisor

January 2016 Issue of Clinical Advisor

Beyond Rx: OTC Corner

Cold and cough 
symptom relief

Safe and effective over-the-counter and herbal treatments are available for patients with viral upper respiratory infections.

Newsline

African American women least likely to benefit from neoadjuvant breast cancer treatment

In a study of over 278,000 patients with stage 1 through stage 3 breast cancer, African American women had the lowest rate of pathologic complete ...

Patients with RA display lower disease activity at NP, PA-staffed practices

Patients with rheumatoid arthritis who are treated at practices with NPs and PAs exhibited lower disease activity over 2 years.

Guidelines for hematologic malignancies in pregnancy

New guidelines have been developed for the diagnosis and treatment of hematologic malignancies during pregnancy.

Initiating alpha-blocker therapy linked to higher risk of stroke in men

Investigators found an increased risk of ischemic stroke among all patients within 21 days following initiation of alpha-blocker therapy.

Ventricle pacing reduces heart failure in chronic kidney disease patients

Researchers found a 15% to 20% reduction in the risk of hospitalization for or death from heart failure in patients who received cardiac resynchronization therapy ...

False-positive mammograms and breast cancer risk

False-positive results on a screening mammogram are associated with a greater risk of developing breast cancer in the 10 years following the result.

Prostate cancer treatment linked to Alzheimer's risk

Patients treated with androgen deprivation therapy had a 1.88-times increased rate of developing Alzheimer's disease.

Shingles increases stroke, MI risk in elderly

Risk of stroke and myocardial infarction may be more than double in the first week following a shingles diagnosis in elderly patients.

Monitoring is advised for adults born preterm

Premature birth has been associated with a number of adverse health conditions.

Better prenatal care, breastfeeding help lower the rate of SIDS

Better pre- and neonatal care, highere rates of breast feeding, and lower rates of smoking during pregnancy have contributed to overall lower rates of infant ...

Advisor Forum

Pap smears, HPV, and screening
 for cervical cancer


Confusion surrounds the current screening recommendations and guidelines.

Pap smear testing
 in a patient who is obese


Correctly position your patient to ensure a proper Pap smear.

Laser therapy for onychomycosis of the toenails


What is the mechanism of action for laser treatment for onychomycosis of the toenails?

Enlarging brown spots:
 a misdiagnosed solar lentigo?

This patient presented for the evaluation of enlarging brown spots.

Ethical concerns with IUDs


For women who are pro-life advocates, copper IUD devices that prevent fertilization may be an acceptable alternative.

Clinical Feature

Primary care clinician risk assessment for hereditary breast cancer

Primary care clinicians should be proficient at assessing the potential for hereditary breast cancer risk in their patients.

Commentary

Full practice authority and opiate use

Federal law does not allow nurse practitioners and physician assistants to prescribe buprenorphine to patients with opiate use disorder.

Alternative Meds Update

Lactobacillus acidophilus may effectively treat gastric infections, autoimmune conditions

Often included in probiotic products, L acidophilus has been studied for its possible impact on a multitude of human ailments.

Evidence-Based Medicine

Vitamin D supplementation does not improve functional outcomes in postmenopausal women

Vitamin D deficiency is especially prevalent in postmenopausal women, and recommendations from current guidelines are inconsistent regarding vitamin D use.

Initiating antiretroviral therapy in HIV patients with CD4 T-cell counts >500 cells/mcL

Recommendations for initiation of antiretroviral therapy (ART) in asymptomatic adults with HIV are generally based on CD4 T-cell counts.

Denosumab may reduce the risk of fracture in women with breast cancer on aromatase inhibitor therapy

Denosumab has been shown to reduce fracture risk in women with breast cancer with bone metastases.

Palliative chemotherapy may reduce quality of life in some patients with end-stage cancer

Palliative chemotherapy in the last month of life may increase the patient's risk of intensive medical treatment and death in an ICU.

Stat Consult

Stat Consult: Influenza 
in children

Learn how to diagnose and treat influenza in children.

Legal Advisor

Undisclosed condition 
leads to death

A patient's widow 
asserts that the clinician
 should have checked
 hospital records taken prior to admission.

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