January 30, 2008 Archives - Page 2 of 12 - Clinical Advisor

Print Issue: January 30, 2008

ANTIBODY INTERLUDE

How soon after exposure to HIV can the presence of antibody be detected by standard Western blot testing?—William K. White, MD, Cordele, Ga. The presence of HIV antibody can be detected by Western blot testing within three to six weeks after exposure (N Engl J Med. 1996;334:1685-1690). Keep in mind, however, that most routine HIV…

DID THIS CABG PATIENT NEED ASPIRIN?

After undergoing coronary artery bypass grafting (CABG), a patient was sent home on clopidogrel (Plavix) but not aspirin. When he presented to the emergency department with acute coronary syndrome (ACS), he was not given aspirin at that time either, the emergency staff claiming that since he was on clopidogrel, he did not need aspirin. Is…

FOOD ADDITIVES MIGHT PROMOTE HYPERACTIVITY IN CHILDREN

Level 2: Mid-level evidence Artificial colors and/or sodium benzoate might increase hyperactivity in children, based on a randomized crossover trial of 153 children aged 3-4 years and 144 children aged 8-9 years in Southampton, U.K. (Lancet. 2007;370:1560-1567). After one week of typical diet (baseline) and one week of withdrawal diet plus placebo drink, children were…

MINOCYCLINE MAY IMPROVE FUNCTIONAL OUTCOME AFTER ACUTE ISCHEMIC STROKE

Level 2: Mid-level evidence The efficacy of minocycline (Minocin) following acute ischemic stroke was evaluated in an open-label randomized trial (Neurology. 2007;69:1404-1410). Patients (N=152) with acute stroke, i.e., within the previous 6-24 hours, were randomized to minocycline 200 mg/day vs. placebo orally for five days and followed for 90 days. One patient was excluded due…

HPV vaccine reduces cervical neoplasia and anogenital warts

Level 1: Likely reliable evidence The Females United to Unilaterally Reduce Endo/Ectocervical Disease (FUTURE) I and II trials evaluated efficacy of the quadrivalent human papillomavirus (HPV) recombinant Gardasil. In the FUTURE II trial, 12,167 nonpregnant women aged 15-26 years were randomized to Gardasil or placebo (N Engl J Med. 2007;356: 1915-1927). All women were asked…

HRT increases risk of cardiovascular disease in older women

Level 1: Likely reliable evidence The Women’s International Study of Long Duration Oestrogen After Menopause (WISDOM) was a randomized trial of 5,692 postmenopausal women aged 50-69 years (mean age 63 years) who were randomized to HRT vs. placebo (BMJ. 2007;335:239). Inclusion criteria included women who demonstrated ≥80% compliance during a 12-week run-in period. Women with…

“The Big Five” hospital expenses, 2005

Hospital expenses continue to explode and are headed toward a trillion dollars in 2008, according to the federalAgency for Healthcare Research. Asthe chart shows, cardiac-related disorders are largely driving the rise in expenses.

IS THIS ERYTHEMA NODOSUM?

A 59-year-old woman has had recurrent painful nodules on both legs for more than three years. Results of previous punch biopsy were nonspecific, although there is a possibility of erythema nodosum (EN). A trial of steroids produced no significant change. In addition, the patient has stage I breast cancer and has had an MI. What…

COUGH-REFLUX LINK

How often is chronic cough due to laryngopharyngeal reflux (LPR)? Are proton-pump inhibitors prescribed for gastroesophageal reflux disease (GERD) effective in the treatment of chronic cough?—Charles S. Winans, MD, Chicago LPR is thought to be a disorder of the upper esophageal sphincter and can be defined as the retrograde movement of gastric contents into the…

Next post in Advisor Forum