August 01, 2009 Archives - Page 3 of 4 - Clinical Advisor

Print Issue: August 01, 2009

Concomitant proton-pump inhibitors and clopidogrel associated with adverse cardiovascular events

Level 1: Mid-level evidenceTwo recent retrospective studies have examined cardiovascular outcomes associated with combining clopidogrel with proton-pump inhibitors (PPIs). A case-control study with 13,636 elderly patients taking clopidogrel after hospitalization for acute MI analyzed PPI use in patients re-admitted for acute MI within 90 days compared with event-free controls (CMAJ. 2009;180:713-718; available at www.cmaj.ca/cgi/content/full/180/7 /713,…

Testosterone receptors and prostate cancer

Is all prostate cancer testosterone receptor-positive?—Mike Hutchins, MD, Missoula, Mont. Yes, all prostate cells have androgen receptors. This is the reason prostate cancer will respond to androgen deprivation. What has puzzled urologists for more than 50 years now is the mechanism of resistance to androgen ablation. Much attention has focused on the androgen receptor as…

Monitoring TB

A college student with a positive result on purified protein derivative (PPD) testing (induration 12 mm) and a negative chest x-ray was treated with nine months of isoniazid. During this period, he was active and felt well. Pertinent history included living in Japan and traveling throughout Southeast Asia until age 4 years. He currently travels…

Interventions may reduce falls in community-dwelling older adults

Level 1: Likely reliable evidence andLevel 2: Mid-level evidenceA Cochrane review examined 111 randomized trials evaluating interventions to prevent falls in community-dwelling older adults (Cochrane Database Syst Rev. 2009;[2]:CD007146). There was strong evidence for the effectiveness of individually prescribed, multicomponent home exercise in a meta-analysis of four trials with 666 adults. Also effective were group…

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