April 2015 Issue of Clinical Advisor

April 2015 Issue of Clinical Advisor


Roadblocks remain in path of generic form of insulin

Without insurance, insulin costs $120 to $400 per month, which can be a substantial barrier to many patients with diabetes.

Anticoagulant use for atrial fibrillation

Anticoagulants are associated with an increased risk for bleeding, but for most patients, the benefits outweigh the bleeding risk.

Lung cancer screening may be inadequate

The current screening criteria for lung cancer may not be sensitive enough to protect people at risk, given the recent decline in smoking rates.

Overimaging is region-based

Inappropriate use of imaging was strongly associated with the hospital referral regions in which patients were treated.

Cardiac screening in low-risk adults

Clinicians should not use resting or stress electrocardiography, stress echocardiography, or stress myocardial perfusion imaging to screen low-risk adults for cardiac disease.

Proper screening of at-risk alcohol users is lacking

Only a minority of primary care providers appropriately screen or intervene with at-risk alcohol users.

Advisor Forum

Keeping an accurate 
medication list is critical 
to a patient's care

Educating patients can help them see the importance of having an accurate medication list.

The benefits of ultrasound
 in women with dense breasts

Even if they are not cost-effective, routine ultrasounds for women with dense breasts are still important.

A mnemonic device for use in cardiology care

Use the acronyms PASS and PAID to remember important murmurs

Providing a calendar page to use
 as a reminder to take medications

Use a calendar page to explain what medications patients should take when.

Urine albumin-to-creatinine ratio is test of choice

Since 2002, the urine test of choice is a urine albumin-to-creatinine ratio (UACR), which is a spot urine test.

Skin lesion leads to diagnosis
 of cutaneous T-cell lymphoma

In diagnosing mycosis fungoides, biopsy is mandatory.

Possible traumatic brain injury 
in a veteran

A nurse practitioner asks about a 21-year-old man who reports that his family is telling him that he is forgetful.

Debating the pros and cons of full-practice authority

Clinicians continue to weigh in on the debate surrounding full-practice authority.

Clinical Feature

Assessing weight-related health risks in a 38-year-old obese woman

A 38-year-old women with severe obesity can be recommended a variety of health interventions based on her health risks.

Dietary fiber: The prebiotic connection

Adequate fiber intake is critical for maintaining good health, but only 5% of Americans consume the recommended daily amount.


Providing health care as a parent

Becoming a parent can provide a new perspective for health care providers working in pediatrics.

Alternative Meds Update

Xylitol: Low-cost treatment for dental caries, upper respiratory infections

Xylitol is a primary sugar alcohol that can be used to help various dental problems as well as upper respiratory and ear infections.

Legal Advisor

Fatal error in admission orders leads to lawsuit

A clinician is sued despite catching an overprescribed medication in a patient's admission orders.

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