After approximately nine months of therapy with a statin (10 mg) and fish oil, my patient’s cholesterol is 131 mg/dL, triglycerides 153 mg/dL, LDL 62 mg/dL, and HDL 38 mg/dL. For how long should the statin be continued? Can it be stopped or taken every other day or every other week?—Mustafa M. Rehab, MD, Greensburg,…
A congenital heart defect complicates a young dad’s diagnosis when he suffers a respiratory infection. Longtime business partners, Drs. A and B considered the period between 1970 and 1990 to be the golden age of American medicine. The practice of medicine has changed since then, though, and they looked forward to retiring. But a malpractice…
A patient claims ignorance of an elevated PSA led to a late cancer diagnosis, despite many clinic visits. Mr. P, 54, felt he had grown old with his patients at a small community clinic in the Northeast. He had been a physician assistant there for almost 25 years. But long-term patient relationships are no protection…
Dr. Kirkby is a family medicine physician in private practice in Pietermaritzburg, KwaZulu-Natal, South Africa, and an editor for DynaMed. Dr. Brown is deputy editor for DynaMed (www.dynamicmedical.com), a database of comprehensive updated summaries covering nearly 2,000 clinical topics. Description • Characterized by restrictive eating to the point of self-starvation, or binge-purging (vomiting, use of…
A 10-day course of prednisolone soon after paralysis begins seems to be your best choice for treating Bell’s palsy. That protocol significantly beat both an anti-viral agent and placebo in a recent double-blind trial. Researchers at the University of Dundee in Scotland recruited 496 patients within 72 hours of developing symptoms. “For many years, clinicians…
Elderly women who enjoy a couple of cups of tea a day have stronger bones than those who abstain, new data show. “Tea drinking was independently associated with higher BMD in the cross-sectional analysis and with a lower reduction in BMD over four years in the prospective analysis,” reported researchers from two universities in Australia.…
The National Kidney Foundation (NKF) has issued a position statement highlighting the availability of two simple tests that can detect chronic kidney disease (CKD) in the majority of patients: a urine test for identifying proteinuria and a blood test for estimating the glomerular filtration rate. “CKD is usually silent until its late stages, thus many…
Empiric use of trimethoprim-sulfamethoxazole (TMP-SMX) to treat uncomplicated UTIs may be contributing to both TMP-SMX resistance and multidrug resistance, it was revealed at the recent Infectious Diseases Society of America meeting in San Diego. New findings from a national database suggest that high levels of resistance to TMP-SMX (>20%) have developed in six out of…
A study reveals that the vast majority of diabetic patients are wearing ill-fitting shoes, setting themselves up for serious, even catastrophic, complications. Poor-fitting shoes are a particular concern for these patients because diabetes-related neuropathy may prevent them from feeling a foot injury. A foot ulcer caused by shoes that irritate or put pressure on the…
A large prospective study has found that five healthy lifestyle habits alone can drastically cut a woman’s chances of a heart attack. Taken together, five low-risk factors averted nine out of 10 initial MIs. Those factors are: • A diet rich in vegetables, fruit, whole grains, fish, and legumes • Moderate alcohol consumption (>5 g/day)…
