What are the dietary recommendations for the three days preceding the oral glucose tolerance test (OGTT)?—G. Tadros, MD, Wilmington, Del. Many centers offering the OGTT recommend eating a balanced diet containing at least 150-200 g of carbohydrate per day for three days before the test. However, a study of pregnant women screened for gestational diabetes…
Does the current standard of care call for stopping Pap smears after age 65 in women with negative Pap histories? Should human papillomavirus (HPV) testing be routine with Pap smears?—Jack Zoldan, MD, Chicago If a woman older than aged 65 years has had three normal Pap smears in the past five years, Pap smear screening…
Even though Murphy’s sign is nonspecific, I use it to aid in diagnosing gallbladder disease in patients with a history of fatty meals leading to abdominal pain. If a hand placed in the medial aspect of the upper right quadrant and a command to take a deep breath elicits pain, I do a hepato-iminodiacetic acid…
A 67-year-old white man, previously with thinning platinum-gray hair, now notes that his hair is turning bright yellow. He has some constipation and recently started fiber supplements. His complete blood count and comprehensive metabolic panel are normal. He takes simvastatin, aspirin, a proton-pump inhibitor, and terazosin, none of which is new to him. Otherwise, he…
Description • Autoimmune lymphocytic infiltration of the thyroid gland closely associated with the presence of antithyroid autoantibodies and often resulting in chronic hypothyroidism• Sometimes associated with a euthyroid state or transient hyperthyroidism• Most common form of chronic thyroiditis ICD-9 code • 245.2 chronic lymphocytic thyroiditis Who is most affected • Females • Peak age of onset: 30-50 years• Inherited as a dominant…
Ezetimibe/simvastatin (Vytorin) was associated with an increased incidence of cancer, based on a secondary analysis of the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) randomized trial.
What are the risk factors for aortic stenosis? What causes calcium buildup in patients with this condition?—MARY LANDSBERGER, ARNP-C, Brandon, Fla. Risk factors for aortic stenosis include a bicuspid aortic valve, radiation, rheumatic fever, atherosclerosis, and untreated strep throat. In rare instances, aortic stenosis is associated with use of certain medications (e.g., ergotamine). Hypercholesterolemia contributes…
Oral rivaroxaban is more effective than subcutaneous enoxaparin for reducing risk of symptomatic deep venous thrombosis (DVT) after total knee arthroplasty.
Tailoring exercise recommendations to meet the unique needs of each patient gives those patients a better chance of meeting the fitness goals they have set with you.
Sancuso uses a transdermal patch system to deliver the anti-emetic, granisetron, to the systemic circulation via passive diffusion. The absorption of drug from the patch is variable from patient to patient.
