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July 2008 11 17 Issue of Clinical Advisor

Newsline

B vitamins fail to cut CV risk

Evidence continues to mount showing that additional folic acid and B vitamin have no effect on the probability of cardiovascular (CV) events, even among high-risk ...

Thyrotropin linked to fatal CHD risks in women

Women's risk of fatal coronary heart disease (CHD) rises with levels of thyrotropin, a hormone that stimulates thyroid function— even when those levels are within ...

Regular mammograms still useful after age 80

Regular mammograms significantly reduce the risk of a late-stage breast cancer diagnosis in women 80 years of age and older, but most are not being ...

Pain meds encourage migraine

Migraine patients who take opioids or barbiturates to control their pain may be making their condition worse, a new study suggests...

ED may indicate future heart trouble

Erectile dysfunction (ED) is a powerful, independent predictor of serious heart disease, according to a pair of recent studies...

Office-based practices with mid-level providers

CDC: Older patients need shingles shot

The herpes zoster (shingles) vaccination is now recommended for people older than 60 years...

Statins may help prevent atrial fibrillation

Another checkmark could soon be added to the "plus" column for statins: These cholesterol-lowering agents also may reduce the risk of atrial fibrillation (AF) in ...

Low-dose aspirin taken at bedtime lowers BP

Timing is everything in aspirin therapy for prehypertension, according to a new study out of Spain...

"Normal" ACR warrants a second look

Women with high but normal albumin/creatinine ratios (ACRs) are much more likely to develop hypertension than women with lower ACRs...

Febrile seizures rarely fatal

Febrile seizures are usually not life-threatening, according to a study of more than 55,000 children...

Self-care can relieve back pain

Clinicians may be able to help patients with chronic back pain overcome discomfort by employing a self-care program known as the Alexander technique...

Drug Updates from MPR

Olopatadine spray for allergic rhinitis

Patanase

Injection to relieve Crohn's symptoms

Cimzia

Combination drug treats migraines

Treximet

Advisor Forum

Three-flu-shot protocol

Should elderly patients be given additional vaccines, or is one shot sufficient?

Controlling health costs

Does this patient have hepatitis B?

Subclinical hypothyroid monitoring

Nonfasting vs. fasting cholesterol goals

The latest on Henoch-Schönlein purpura

Managing hypertension in a breastfeeding mother-to-be

Angioedema incidence in athsma patients

How frequently does angioedema develop in asthmatic patients who are just starting montelukast?

Women face extra antibiotic risks

Risks of short-term high blood sugars

Alendronate and nonhormonal breaks?

When to use serologic assays for HSV

Life expectancy without a pacemaker

Creatinine increase after ACE inhibitor

Is pancreatic cancer on the rise?

Is it time to stop indomethacin for gout?

Indomethacin is harder on the stomach than most other nonsteroidal anti-inflammatory drugs.

Inhaled steroid for bronchitis?

Managing hepatitis C

Cholesterol effect of spironolactone

What adverse effects are associated with this acne treatment?

Role of D-dimer in suspected thromboembolism

Add a bisphosphonate to raloxifene?

Incontinence during sleep

The effects of long-term opioid use

Oral vs. SC diabetes medications

Cardiac parameters at odds

How to tell tonsillitis from mono

Cover Feature

A short course in topical psoriasis agents

Unsightly skin can cause patients great anguish, raising their frustration with slow or ineffective therapies. This is the approach used by one expert.

Clinical Feature

Minimize adverse drug reactions in the elderly

Slower metabolism, compromised adherence, and potential interactions present new challenges as patients get older. Here's how to manage them.

Are you treating BP aggressively enough?

According to new recommendations, patients once considered to be "prehypertensive" now require more than just lifestyle modification.

Preoperative evaluation: Take it step by step

Identifying patients at higher risk for mortality and morbidity during the perioperative period can lead to strategies to minimize those risks.

The role of clinicians in smoking cessation

The number of effective treatments to deter tobacco use is larger than ever. We offer a brief summary of what the experts recommend.

Dermatologic Look-Alikes

White eruptions on the penis

Clinical Challenge

Gastroenterology searches for cause of patient's anemia

After looking at the man's history, physical exam, and lab results, colonoscopy was scheduled. Find out what was discovered.

Was Mrs. W's back pain preventable?

Her discomfort could have been from inevitable arthritis, but there were signs of a different diagnosis.

Commentary

Raise vaccine rates in primary care

Are we providing recommended vaccines to our patients? The answer is no.

Alternative Meds Update

Turmeric

Turmeric has long been used in both Ayurvedic and Chinese medicine as an anti-inflammatory, to treat digestive disorders and liver problems, and for the treatment ...

Dermatology Clinic

Inflammation and vesicles on a wrestler's feet

An 18-year-old high school wrestler presented with recent onset of itchy, small blisters on the feet.

Erythema and bruising that turned painful and pruritic

A 64-year-old man presented with a progressively worsening pruritic eruption on his left upper back.

Asymptomatic cystic scrotal bumps of 40 years' duration

A 46-year-old man complained of multiple cystic bumps that had been present on his scrotum as long as he could remember. There was no itching, ...

Scaly, atrophic rash on the face and back of a newborn

A Caucasian girl, born to a gravida 2, para 2-0-0-2 mother, presented two days after birth with an erythematous, scaly, atrophic rash primarily in the ...

Evidence-Based Medicine

Structured group education for new type 2 diabetes patients

The Diabetes Education and Self Management for Ongoing and Newly Diagnosed (DESMOND) program for patients with type 2 diabetes was evaluated in a cluster-randomized trial...

Point-of-care anticoagulation monitoring vs. lab-measured INR

For patients on long-term oral anticoagulation therapy, use of point-of-care devices is associated with lower rates of death and major thromboembolic events compared with laboratory ...

Erythropoietin or darbepoetin in cancer patients with anemia of chronic chronic disease

Erythropoietin or darbepoetin may reduce the need for transfusions, but their use was associated with increased risk of venous thromboembolism...

Combination ramipril plus telmisartan not beneficial in patients without heart failure

A combination of ramipril (Altace) 10 mg daily plus telmisartan (Micardis) 80 mg daily does not reduce mortality or cardiovascular morbidity compared with ramipril alone...

Stat Consult

Essential tremor

Involuntary rhythmic and oscillatory movements of body part due to alternating contraction of opposing muscle groups not resulting from other disease or medication