April 25th 2025
Phenomix will showcase new data on prediction of adverse events to GLP-1 RA therapy, a new obesity sub-phenotype, and approaches to improve surgical outcomes.
Osteoporosis Prophylaxis: Menostar Now FDA-Approved
January 1st 2007The FDA has approved the use ofan estradiol transdermal system(Menostar), from Berlex LaboratoriesInc., to prevent osteoporosis in postmenopausalwomen. The hormoneis impregnated in a dime-sized, once a-week patch that delivers 14 μg/d ofestradiol: this dosage is half that ofother currently available transdermalestrogen patches. No supplementaryprogestin therapy is generally needed.This product can be prescribed for women who are without a uterus.The most common side effects areirritation at the patch site, joint pain,and leukorrhea.
Cataracts:The Case for Earlier Surgery
January 1st 2007Cataracts areone of themost importantcauses ofreversibleblindness in elderly persons.1 A recent report thatpredicts a surge in cataractincidence has heightenedawareness of the importanceof proper timing andtechniques for cataract extraction.The study, authoredby the Eye DiseasesPrevalence ResearchGroup, estimated that thenumber of Americans withcataracts will increase byapproximately 50% in thenext 20 years as the populationages.2 Cataracts werethe leading cause of low vision(less than 20/40 bestcorrected visual acuity inthe better-seeing eye)among whites, blacks, andHispanics.
A Photo Quiz to Hone Dermatologic Skills
January 1st 2007For several weeks, a 68-year-old man has had painful blisterson his hands that crusted as they healed. The patienthas diabetes mellitus, hypertension, and chronic renalfailure, for which he is undergoing hemodialysis. His longtermmedications include a hypoglycemic agent and adiuretic.
Woman With Chest Pain, Fever, and Cough
January 1st 2007A 62-year-old woman presents with severe, sharp pain in her right mid chestthat worsens when she breathes. The pain began the previous night, shortlyafter she had been awakened by a shaking chill, followed by the sensationof fever. She also has a relatively nonproductive cough of recent onset.
Can the Ottawa Ankle Rules Rule Out Arthritis?
January 1st 2007The Ottawa ankle rules are said to help in ruling out ankle fractures and cuttingdown on needless ordering of roentgenograms. How effective are they in differentiatingbetween strain or sprain and inflammatory or noninflammatory arthritis inthe ankle?
Young Man With a History of Vague Headaches Ascribed to Sinusitis
January 1st 2007A 37-year-old man found unresponsiveat home with erratic respiration andurinary incontinence was brought tothe emergency department (ED). Accordingto his family, the patient hadbeen complaining of headaches, vertigo,and mild neck pain for 2 months.During that time, a CT scan of thesinuses revealed chronic sinusitis; thepatient had completed a course ofprednisone, naproxen, and meclizinewithout symptomatic improvement.The day before he was brought to theED, he had presented to a differenthospital with the same complaints andwas given a prescription for antibioticsfor a presumed sinus infection. He haddiet-controlled hypercholesterolemiaand did not smoke.
Woman With Exertional Dyspnea, Weakness, and Dizziness
January 1st 2007A 66-year-old woman presents tothe emergency department(ED) with exertional dyspnea, generalizedweakness, and orthostaticdizziness; the symptoms startedabout 1 week earlier and have progressedinsidiously. The patient alsoreports diaphoresis and nausea withoutvomiting. She has no chest pain,palpitations, cough, or hemoptysis;she has not had a recent respiratorytract infection. While she is waitingto be admitted, she has an episode ofsyncope.
Subclinical Hypothyroidism: Why Wait to Treat?
December 31st 2006In his article, “Subclinical Hypothyroidism: When to Treat, When to Watch?”(CONSULTANT, April 1, 2004, page 533), Dr Vahab Fatourechi notes that thereis some evidence that subclinical hypothyroidism has adverse effects on cardiovascularfunction that may contribute to left ventricular systolic dysfunction with effort.
A Photo Quiz to Hone Dermatologic Skills
December 31st 2006A 38-year-old overweight woman presents with an asymptomatic rash ofat least 2 months’ duration that had not responded to a combinationcorticosteroid/antifungal agent. She has mild hypertension and type 2 diabetesmellitus that is being managed with diet and exercise. She is otherwisehealthy.
Aspirin Therapy to Prevent CVD in Patients With Diabetes: Recommendations From the ADA
December 31st 2006Men and women with diabetes are 2 to 4 times more likelythan other persons to die of complications of cardiovasculardisease (CVD). Solid evidence from primary andsecondary prevention trials has prompted the AmericanDiabetes Association to recommend low-dose aspirin therapyfor patients with diabetes who either have or are athigh risk for CVD (Table).
Gestational Diabetes: Worth Testing For? Worth Treating?
December 31st 2006Is there evidence that treating elevated fasting glucose levels or impairedglucose tolerance, from early in pregnancy until term, improves outcomes(ie, fewer cesarean deliveries, fewer macrosomic babies, fewer patients in whompreeclampsia develops, fewer mothers who subsequently require insulin)?
Older Woman With Nonhealing Foot Ulcer
December 31st 2006A 67-year-old woman has had an ulcer on her left heel for at least several weeks.She applied a homemade dressing and cut her shoes to try to relieve pressureon the ulcer; however, in the past week, areas around the ulcer have becomepainful. These areas, as well as the dorsum of the foot, are red and swollen.