June 2010 Issue of Clinical Advisor

June 2010 Issue of Clinical Advisor

Newsline

Don't abandon fruits, vegetables despite weak link in cancer risk

Fruits and vegetables remain important components of a healthful diet.

Added sugars can cause problems with blood fats

Research shows an average of 15.8% of calories consumed came from added sugars.

Stroke survivors can regain movement

The study provides evidence of the potential for long-term benefits of intensive rehabilitation in patients with moderate-to-severe impairment.

Attacking Alzheimer's through diet

Limiting high-fat dairy products, red meat, organ meat, and butter may cut a person's risk of Alzheimer's disease.

Glucose control may improve GI symptoms

Better glycemic control reduces upper GI symptoms in people with diabetes.

Early COPD detection feasible

PCPs should screen people with known risk factors for COPD.

Skin-cancer screening lags in older adults

Screening rates are considerably lower than those for breast cancer, prostate cancer, and colorectal cancer.

Aspirin often works for migraine pain

A single aspirin dose can substantially reduce moderate-to-severe migraine pain within two hours.

New vitamin D recommendations to reduce falls and fractures

The response to vitamin D3 supplementation is not affected by age or usual calcium dietary intake.

Advisor Forum

Dangers of long-term nasal steroid use

What are the the long-term effects of steroid nasal sprays?

Depo-Provera injection site

Deltoid or gluteus?

Treating reflux in an infant

Should PPIs be used?

Relief from leg cramps

Since quinine is no longer safe, what alternatives are there?

Lymphedema treatment options

Lymphedema often turns into cellulitis in patients with diabetes.

Monitoring phenylalanine in patients with phenylketonuria

Is it necessary to routinely measure levels of blood phenylalanine in adults with a history of PKU?

Cervical adenocarcinoma after hysterectomy

What should be done after Pap smears confirmed adenocarcinoma in situ, and two vaginal biopsies were negative?

Herbal solution to decreased libido?

Can maca root help women with decreased libido resulting from selective serotonin reuptake inhibitor use?

Extracting glass slivers

A little fluorescent dye may be helpful.

Urinary tract symptoms and genital herpes

Consider genital herpes in the differential diagnosis of chronic dysuria.

HPV in the oral cavity

HPV lesions can lead to the development of oral cancers.

Post-bariatric surgery prescription drug use

Post-bariatric patients should not take extended-release medications.

Tetanus booster failure

Why did immunization fail?

Decreased libido following hormone therapy

If a patient has reduced libido on oral estrogen, a transdermal product should help.

Clinical Feature

New data guide update on panic disorder

This disabling condition interferes with daily functioning and can cause significant distress. Pharmacotherapy is not the only treatment option.

Common pediatric hip diseases in primary care

Left untreated, these childhood conditions could have lasting effects. Our experts explain three of the most common hip disorders you'll see.

Dermatologic Look-Alikes

Enlarging back and shoulder lesions

Two patients with enlarging lesions—one in a man with no history of skin cancer, and the other in a man with significant actinic damage

Clinical Challenge

Prescription and OTC creams ineffective against itchy lesions

The patient's physical and psychological discomfort upset every aspect of his life.

Commentary

Patients deserve to hear tough news

Research shows that most Americans would want to know if they were severely ill and likely to die.

Alternative Meds Update

L-arginine used for heart failure and erectile dysfunction

This amino acid is mainly taken for its vasodilatory effects, but serious safety issues limit its use.

Dermatology Clinic

Scaly plaques spread from head to toe

Five months of treatment with corticosteroids and antibiotics did not relieve the scaly rash on a man's scalp, cheeks, trunk, genitals, and legs.

Rash preceded by fever and cough

After four days with a high fever, cough, and conjunctivitis, a child is brought to the hospital with an extensive, maculopapular rash.

Evidence-Based Medicine

Moderate alcohol consumption in women may reduce overweight or obesity

Red wine was associated with the greatest risk reduction

Questionnaire may detect major depression in adolescents

Patients were asked how often in the past two weeks they had experienced a depressed mood and how often they had a lack of pleasure ...

Rifaximin may improve remission and reduce hospitalization for hepatic encephalopathy

Hepatic encephalopathy is a common complication of liver cirrhosis.

Legal Advisor

Amputation results from diabetes

Should a noncompliant patient bear the full responsibility for not following instructions?

Four steps to follow when dismissing a patient

Once you've made the decision to dismiss a patient, make sure you finish the job.

Hospital not liable for kidney transplant cancer death

The case involved the death of a 37-year old man who died from cancer and receiving a kidney from a woman who had uterine cancer.

Practice environment is on the decline in Massachusetts

The drop is attributed to professional liability rates, the percent of physicians over 55 years of age, the cost of maintaining a physician's practice, and ...

Las Vegas physician indicted following hepatitis outbreak

The outbreak was caused by the reuse of syringes and endoscopy scopes.

Breach in emergency chain of command results in malpractice lawsuit

A hospital is sued because there was no protocol in place for a patient facing a life-threatening condition.

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