Print Issue: September 01, 2009

Potential hair-replacement procedure risks

What potential risks are involved with hair-replacement procedures?—MARY DESANDOLO, FNP, Waccabuc, N.Y. Risks potentially associated with hair-replacement procedures include excessive bleeding (during and after the procedure), infection, and scarring. Another potential problem is that the grafts will not take (resulting in death of the hair follicles) after they have been transferred from their donor sites…

Blood from a patient with severe iron deficiency anemia

Anemia complicates CHF

Chronic heart failure (CHF) patients with anemia are more likely to face adverse outcomes than those without anemia, according to a recent meta-analysis.

Water immersion during labor reduces analgesia use

Level 1: Likely reliable evidence A Cochrane review of 11 randomized trials evaluated the safety and efficacy of water immersion during the first stage of labor (Cochrane Database Syst Rev. 2009;[2]:CD000111). Water immersion, which involves complete abdominal submersion in a bath or pool, reduced both maternal pain and epidural and spinal analgesia requirements. Analgesia/anesthesia use…

Topical estrogen for postmenopausal women

Is there a recommended duration of topical estradiol therapy for postmenopausal women with symptoms of vulvovaginal atrophy? Would progesterone help counteract endometrial hyperplasia? If so, is there a recommended dosage and frequency?—MORGAN STRYKER, PA-C, Santa Cruz, Calif. Risk and benefits of estrogen therapy must be individualized. While estrogens are very effective in alleviating postmenopausal symptoms…

Subcutaneous vs. IV insulin

I have heard that we can give subcutaneous (SC) regular insulin every one to two hours instead of giving an IV infusion. Is that true?—Dennis A. Fito, MD, Oklahoma City While in theory this may be true, practically speaking, the varied absorption rates of SC insulin make this an unreliable way of managing conditions that…

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