Page 1924 – Clinical Advisor

TENNIS ELBOW SYMPTOMS REDUCED BY PHYSICAL THERAPY MORE THAN BY STEROIDS

Level 1: Likely reliable evidence The treatment of lateral epicondylitis (tennis elbow) was evaluated in 198 patients who had the condition for at least six weeks (i>BMJ. 2006;333:939; full-text available online free of charge at www.bmj.com/cgi/content/full/333/7575/939. Accessed January 9, 2007). Patients aged 18-65 years were assigned to one of three groups: physiotherapy vs. corticosteroid injections…

NP-We’ve got targets on our backs!

I’m worried—and you should be, too. Nurse practioners are increasingly likely to be sued for malpractice. It’s not because we’re practicing bad medicine, of course, but because we’ve got targets on our backs. Let me explain. </p? Recently, a man in his 20s showed up at a local clinic with respiratory symptoms, fever and a…

Noxafil- Liquid agent for Candida, Aspergillus

Product: Noxafil Company: Schering Pharmacologic class: Antifungal (triazole) Continue Reading Active ingredient: Posaconazole 40 mg/mL; oral suspension; cherry flavor. Indication: Prophylaxis against invasive Aspergillus and Candida infections, in patients at high risk due to being severely immunocompromised, such as hematopoietic stem cell transplant recipients with Graft vs. Host Disease (GVHD) or those with hematologic malignancies…

Zelapar – reduces “off time” in Parkinson’s

Company: Valeant Pharmacologic class: Antiparkinson agent (MAO-B inhibitor) Active ingredient: Selegiline 1.25 mg; orally-disintegrating tabs; contains phenylalanine. Continue Reading Indication: Adjunct in Parkinson’s disease in patients with deteriorating response to levodopa/carbidopa. Pharmacology: Zelapar is an orally disintegrating tablet form of selegiline that disintegrates within seconds after placement on the tongue and which is then rapidly…

Xolegel- Antifungal skin gel relieves scaly rash

Company: Barrier Therapeutics Pharmacologic class: Topical antifungal (azole) Active ingredient: Ketoconazole 2%; topical gel (anhydrous). Continue Reading Indication: Topical treatment of seborrheic dermatitis in immunocompetent patients. Pharmacology: Seborrheic dermatitis is a chronic inflammatory skin disorder that is characterized by a red, itchy, scaly rash typically occurring on the face, scalp, hairline, and trunk. Ketoconazole acts…

USE ENOXAPARIN INSTEAD OF IV HEPARIN?

The IV heparin recommended by Peter F. Cohn, MD, as bridging therapy when warfarin has to be stopped in a pa-tient with an artificial heart valve (Item 99-12) requires a long hospital stay. Why not use outpatient enoxaparin, withholding a dose 12 hours before the procedure and continuning postoperatvely until the international normalized ratio is…

Duetact- Two diabetes meds in one daily tablet

Product: Duetact Company: Takeda Pharmacologic class: Antidiabetic (thiazolidinedione + sulfonylurea) Continue Reading Active ingredients: Pioglitazone (as HCl) 30 mg, glimepiride 2 mg; tabs. Also: Duetact 30 mg/4 mg Active ingredients: Pioglitazone (as HCl) 30 mg, glimepiride 4 mg; tabs. Indication: Adjunct to diet and exercise in type 2 diabetes in patients already on pioglitazone +…

Nocturnal Leg Cramps

Dr. Kirkby is a family medicine physician in private practice in Pietermaritzburg, KwaZulu-Natal, South Africa, and an editor for DynaMed. Dr. Alper is medical director of clinical reference products for EBSCO Publishing, in Ipswich, Mass., and editor-in-chief of DynaMed (www.dynamicmedical.com), a database of comprehensive updated summaries covering nearly 2,000 clinical topics. Description • Involuntary nighttime…

Depression torpedoes asthma therapy

Frustrated with your adult asthma patients’ poor adherence to their treatment regimens? They may suffer clinical depression, and if you treat it, their asthma might improve. This conclusion comes from two related but separate studies. In the first, investigators at The Johns Hopkins School of Medicine in Baltimore studied 59 middle-aged, inner-city adults hospitalized for…

Too many colonoscopies?

There’s increasing evidence that clinicians recommend post-polypectomy colonoscopies more often than necessary. A group of researchers led by Vikram Boolchand, MD, at the University of Arizona Health Sciences Center in Tucson, asked 1,000 internists and family practitioners when they would recommend repeated colonoscopy for a hypothetical 55-year-old man with no family history of colorectal cancer…

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