October 01, 2009 Archives - Clinical Advisor

Print Issue: October 01, 2009

Step-by-step chest tube removal

When removing a chest tube, first stack a Xeroform Petrolatum gauze dressing on a nonadhesive dressing. Tape three sides of the dressing over the tube with foam tape. While keeping a fourth piece of tape ready, snip the sutures holding the tube in place. Put gentle pressure on the dressing with one hand while swiftly…

Insulin therapy associated with dose-dependent increase in risk for cancer

Level 2: Mid-level evidence A recent observational study evaluated the malignancy rates associated with human insulin and insulin analog in 127,031 adults with diabetes receiving first-time insulin monotherapy (Diabetologia. 2009;52:1732-1744). All participants were without known malignant disease at baseline; 75% were treated with human insulin and 19% with insulin glargine exclusively. Others received either insulin…

Preoperative medical testing prior to removal of a cataract (shown) had no effect on adverse events

Routine preoperative testing not beneficial prior to cataract surgery

Level 1: Likely reliable evidence A recent Cochrane review of three randomized trials evaluated the addition of routine medical testing to standard preoperative history and physical exams prior to age-related cataract surgery. Routine preoperative testing included ECG; complete blood count; electrolyte, blood urea nitrogen, creatinine, and blood glucose determinations, regardless of indications. In 21,531 operations,…

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