August 01, 2009 Archives - Clinical Advisor

Print Issue: August 01, 2009

Screening for asymptomatic CAD may not reduce cardiac events in diabetes patients

Level 2: Mid-level evidencePatients with diabetes are known to be at increased risk for coronary artery disease (CAD) as well as silent ischemia. The Detection of Ischemia in Asymptomatic Diabetics (DIAD) trial evaluated using adenosine-stress radionuclide myocardial perfusion imaging to screen 1,123 patients with diabetes who had no cardiovascular symptoms (JAMA. 2009;301:1547-1555). Results showed no…

Complex carbohydrate intolerance?

What risk factors or predisposing factors are associated with complex carbohydrate intolerance (CCI)? Is this a sign of another underlying disorder?—JAN MAILLOUX, PA-C, Mineral Point, Wis. CCI is not a term I was familiar with. A Web site (www.preventcci.com) dedicated to this malady suggests that it refers to the inability of the human digestive tract…

Elevated D-dimer and pulmonary embolism

In the absence of any weighted clinical signs of a pulmonary embolism (PE), what D-dimer measurement would warrant an expensive CT workup?—RICH MOORE, PA-C, Bulls Gap, Tenn. Attempts at more conservative diagnostic therapy prior to doing a CT are evaluating the relationship between elevated D-dimer levels and PE. However, many conditions can elevate D-dimer, and…

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