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May 2009 12 5 Issue of Clinical Advisor

Newsline

Aspirin guidelines push stroke prevention

New recommendations call for at-risk men aged 45-79 years to take aspirin daily to prevent a primary heart attack. Similarly, at-risk women aged 55-79 years ...

More vitamin C may mean less gout

A large, long-term study links higher vitamin C intake with a lower risk of gout

Fractures may herald more breaks in future

Women who sustained a proximal humeral fracture were more than five times as likely to break a hip within a year as women whose bones ...

Kidney function affects warfarin action in patients with CKD

Patients with kidney impairment seem to require lower doses of warfarin and may need closer monitoring to avoid serious bleeding complications.

Glucose control and cardiovascular disease

Is it more important to control fasting blood glucose levels or postprandial spikes?

Which diet: High-carbohydrate, high-protein, or high-fat?

Regardless of which macronutrient is emphasized, the person will lose weight as long as calories are being reduced.

Six melanoma risk factors identified

New factors have been identified that could increase risk of melanoma.

Diabetes, high LDL speed Alzheimer's decline

A history of diabetes or high cholesterol (especially LDL) can speed cognitive decline in patients with Alzheimer's disease.

Earlier colorectal cancer screening for African Americans advised

African American patients should begin screening for colorectal cancer at age 45 years rather than age 50.

Drug Updates from MPR

New drug to treat overactive bladder

Toviaz works by relaxing the smooth muscle tissue of the bladder.

Once-daily hyperuricemia management

Uloric helps prevent uric acid production in patients with gout.

Advisor Forum

Getting high blood sugar levels under control

A 70-year-old man with a history of type 2 diabetes takes insulin glargine (Lantus) 100 units every morning and insulin aspart (Novolog) 20 units with ...

Zoster vaccine while on arthritis meds

Is restless legs syndrome related to tremor?

Of what value are folate levels?

Periorbital rash with angioedema

Sterilization vs. tubal ligation

Vitamin D prophylaxis for osteoporosis?

Shouldn't vitamin D deficiency be considered the primary risk factor?

Why the prostate grows with age

Prophylactic montelukast?

Should nightly dosing continue only through "cold season?"

What to do for fatty liver

Post-hormone therapy breast cancer risk

How long does the risk of breast cancer remain elevated after a woman stops hormone therapy?

Iron deficiency anemia in a vegetarian

Hyperlipidemia -- not just the numbers

A pressing need for nail disorders

Cover Feature

Chronic dysfunction of the eustachian tube

Presenting complaints include hearing loss, persistent pain, or "clicking" in the ear. Patients must allow time for treatment (if required) to take effect.

Clinical Feature

Epileptic seizures in older adult patients

The conclusion of this two-part report looks into the management and therapeutic options available to clinicians treating this population.

Dermatologic Look-Alikes

Two erythematous leg rashes

Two women with considerable comorbidities present with lower leg trouble.

Clinical Challenge

Muscle soreness in a fit young woman

The patient exercised regularly, so what caused swelling and soreness after a single exercise class?

Commentary

Medical homes: A feasible concept?

Alternative Meds Update

Probiotics

Probiotics are used to maintain a homeostatic balance of bacteria in the gut.

Dermatology Clinic

Asymptomatic red plaque on the hand of a diabetic patient

A 35-year-old Caucasian woman with diabetes mellitus was referred to us for evaluation and assessment of a slowly enlarging lesion that had first appeared on ...