September 6th 2024
Across two clinical trials in the QWINT program, once-wekly efsitora showed comparable A1C reduction to frequently used daily insulins.
Superior Vena Cava Thrombosis Caused by Malignancies
September 15th 2002A 64-year-old woman with a history of diabetes, hypertension, and lymphoma was admitted to the hospital with a dull headache, conjunctival congestion, and slight dyspnea. Her pulse rate was 96 beats per minute; blood pressure, 146/68 mm Hg; and respiration rate, 22 breaths per minute. She also had increased jugular venous distention; cardiovascular and chest examination findings were normal. Edema of both arms and dilated blood vessels on the anterior chest wall were noted.
Heart Failure Treatment: What Role for ARBs?
September 1st 2002Heart failure(HF), the mostcommon Medicarediagnosisrelatedgroup,has a significant and growingimpact on health careresources. The incidenceof HF has tripled during thelast decade. Almost 5 millionAmericans have HF, and anestimated 500,000 new casesare diagnosed yearly. Thelifetime risk of HF is about20%.1 Drug therapy has improvedconsiderably in recentyears, but the magnitudeand severity of theproblem has created a needfor newer therapies--particularlysince HF is associatedwith an increased risk ofsudden death and a diminishedquality of life.2
Three Cases of Hyperpigmentation of Pregnancy
September 1st 2002Some degree of hyperpigmentationdevelops in most pregnantwomen. This coloration is more pronouncedin dark-skinned women; onnaturally pigmented areas, such as theareolae, perineum, and umbilicus; andon the axillae, inner thighs, and otherregions that are prone to friction.
Drug Therapy for Type 2 Diabetes:Questions and Caveats
August 2nd 2002Dr Gregory Rutecki's interactive teaching case, “A Middle-Aged Man WithPolyuria: The Initial Visit” (CONSULTANT, March 2001, page 357), provided awelcome opportunity for me to review the care I provide to my patients with type 2diabetes, who comprise a very large percentage of my practice.
Antihypertensive Treatment: How to Maximize Results for Your Patients
July 1st 2002Q:Many of my patients appear to have white-coathypertension: their pressure is elevated whenmeasured in my office-but normal when measured athome. Am I ignoring significant hypertension if I do nottreat these patients? Or am I overtreating if I do treat?
Acquired Reactive Perforating Collagenosis on a Woman's Back
June 1st 2002Highly pruritic, 2- to 4-mm, papular lesions with central ulceration erupted on the back of a 66-year-old woman. She had had 2 similar outbreaks in the past. The patient was taking conjugated estrogens, alprazolam, and alendronate.
Small Left Colon Syndrome in Infants
June 1st 2002Affected infants present shortly afterbirth with a large bowel obstructionsecondary to transient dysmotility inthe descending colon. Although thecause is unknown, immaturity of thecolonic myenteric plexuses has beendemonstrated in some cases. Morethan 50% of affected infants are bornto mothers with diabetes. Other predisposingfactors include hypoglycemiaand sepsis.
Tight Skin in a Patient With Diabetes
May 1st 2002This patient with long-standing insulin-dependent diabetes has difficultyclosing his hand because of “tight skin.” Diabetes is the cause: this findingoccurs more often in persons with microvascular complications, such asretinopathy and nephropathy. The condition may occur even in patients withwell-controlled diabetes.
Diabetic Retinopathy in a 56-Year-OldMan
May 1st 2002Diabetic retinopathy is the most common cause of legal blindness in personsbetween the ages of 20 and 65 years. In this 56-year-old man with a 20-yearhistory of type 2 diabetes, multiple, scattered intraretinal (dot-blot) hemorrhagesand superficial nerve fiber layer (splinter) hemorrhages can be seen.An occasional Roth spot-an intraretinal hemorrhage with a white center thatrepresents a fibrin thrombus which occludes a ruptured blood vessel-is alsoevident. Numerous yellow, waxy, hard exudates are seen between the innerplexiform and inner nuclear layers of the retina. Cotton-wool spots are alsopresent, although no neovascularization is present.
Necrobiosis Lipoidica Diabeticorum
May 1st 2002The atrophic patches on the lower legs of this 47-year-old woman who has haddiabetes mellitus for over 20 years are those of necrobiosis lipoidica diabeticorum.These areas involve degeneration of collagen and elastic fibers in thelower dermis and changes in blood vessel walls. The lesions usually begin assingle or multiple elevated reddish nodules, most commonly in the pretibialarea. Over time, they expand and coalesce into distinctive brownish yellowpatches. These areas may be somewhat tender, but as they spread, theyfrequently become painless-unless they ulcerate. Because the involved skinis fragile, ulcers can form after any minor trauma.
Menstrual Migraine: How "Mini-Prophylaxis" Can Work for Your Patient
May 1st 2002Migraine is an episodic, often debilitatingcondition that affects women moreoften than men. Twenty-eight millionAmericans suffer from migraineheadaches-and nearly 75% of theseare women.1 Unlike other chronic painconditions, migraine has its peakprevalence during the years of greatestproductivity, when most women arejuggling family responsibilities andcareers.2 Many women are particularlysusceptible to migraine attacks justbefore and during menses.
Prednisone for Stevens-Johnson Syndrome
April 15th 2002Levofloxacin, 500 mg/d, had been prescribed for a 74-year-old woman who had a urinary tract infection. The patient had type 2 diabetes and hypertension. She was allergic to sulfa drugs. Two hours after taking the first oral dose of the antibiotic, painful blisters developed on the lower lip and soft palate.
Dyslipidemia: Rational Use of the Statins
January 1st 2002Although the cardiovascular death ratehas declined in the United States, thenumber of hospitalizations for cardiacdisease has not. The improvement incare has been offset by an increase inthe number of older Americans. By2050, more than 100 million Americanswill be 60 years of age or older,and about 30 million will be older than80 years.