November 22nd 2024
Your daily dose of the clinical news you may have missed.
Xenical 'Lite' Gets New Name and FDA Nod for OTC Sales
February 7th 2007ROCKVILLE, Md. -- The FDA today approved over-the-counter sale of a low-dose version of Xenical (orlistat), a prescription diet drug that works by blocking the absorption of fat in the intestine. The OTC version will be called Alli.
Blastoschizomyces capitatus infection in an immunocompetent man
February 1st 2007Blastoschizomyces capitatus is an emerging pathogen that causes infection primarily in patients who have immune system dysfunction. The author reports a case of pulmonary blastoschizomycosis in an immunocompetent man who was successfully treated with voriconazole.
Assessing the cause of symptoms in a patient with thyroid cancer
February 1st 2007A 75-year-old woman had undergone a total thyroidectomy, with histologic evidence of poorly differentiated follicular thyroid cancer. She subsequently received an ablative dose of iodine-131. After a disease-free interval of about 2 years, she presented with evidence of recurrence in the thyroid bed. She had enlarged cervical lymph nodes and complained of dyspnea on exertion.
What caused these findings in a patient with atrial fibrillation?
February 1st 2007A 69-year-old man with a history of atrial fibrillation, pulmonary embolism, asthma, and obstructive sleep apnea presented to the emergency department for evaluation of dyspnea and light-headedness. He had been treated for paroxysmal atrial fibrillation over the past 5 years; fairly good control had been achieved with metoprolol and amiodarone. However, over the past several months, he had been experiencing intermittent episodes of atrial fibrillation.
Heart Failure: Patient Selection and Treatment
February 1st 2007ABSTRACT: Angiotensin-converting enzyme (ACE) inhibitor therapy is recommended for all patients with heart failure (HF) and a reduced ejection fraction. It is generally initiated in the hospital at low doses as inotropic therapy is tapered. Angiotensin II receptor blockers may be a suitable alternative for patients who cannot tolerate ACE inhibitors. For patients who cannot tolerate either class of drug, a combination of hydralazine and a nitrate is recommended. ß-Blockers are first-line therapy for patients with current or previous symptoms of HF and reduced left ventricular function, as well as all patients hospitalized for HF. An aldosterone antagonist may be added to the regimen of patients with moderately severe to severe symptoms and reduced ejection fraction whose renal function and potassium concentration can be monitored.
Plantar Fasciitis: Office Management
February 1st 2007ABSTRACT: Heel pain that occurs with the first several steps in the morning and diminishes as walking continues is the classic symptom of plantar fasciitis. Assessment of risk factors, such as improper footwear, a change in physical activities, and a new running surface, is important. Radiographs are rarely useful. Plantar fasciitis is generally self-limited; symptoms typically take 6 to 18 months to resolve. Conservative measures may include relative rest, stretching, strengthening, shoe modifications, orthoses, night splints, NSAIDs, and ice therapy. A corticosteroid injection may be warranted in resistant cases. If extensive conservative treatment is unsuccessful, referral to an orthopedic surgeon may be indicated.
Middle-Aged Woman With Severe Abdominal Pain
February 1st 2007A 48-year-old woman is evaluated for transfer to the ICU. She presented to the emergency department 48 hours ago with severe abdominal pain and emesis. The pain had started several days earlier and was located in the upper abdomen with some radiation to the back. No position--even the fetal position--provided relief. After admission, she was given intravenous fluids and analgesics; in the last several hours, her condition has deteriorated. She now complains of thirst and is somewhat agitated.
Right-Sided Infective Endocarditis
February 1st 2007For a week, a 39-year-old woman with a history of intravenous heroin use had generalized pain, fever, chills, and a nonproductive cough. She rated the pain at 10 on a scale of 1 to 10; it was sharp, constant, and unrelieved by heroin. She also reported dyspnea at rest, pleuritic chest pain, and a 15-lb weight loss over the past month. She had no significant medical history or drug allergies, smoked a half pack of cigarettes per day, and denied alcohol use.
Air Pollution Linked to Increased Cardiovascular Events and Death in Postmenopausal Women
January 31st 2007SEATTLE -- Fine-particulate air pollution over time significantly increased the risk of a first heart attack or stroke, as well as cardiac mortality, in postmenopausal women, researchers here reported.
STS: CT Angiography Promising but Not Ready to Supplant Catheter Cousin
January 31st 2007SAN DIEGO -- Although computed tomography angiography showed striking results in a small study reported here among patients with known heart disease, the decision to proceed with a coronary bypass still seems to need a visit by a catheter.
Human Growth Hormone No Fountain Of Youth
January 15th 2007STANFORD, Calif. -- The fact that Ponce de Leon grew old and died should have been an object lesson, but the search goes on for the fountain of youth. Take human growth hormone, a recent popular and expensive candidate. No way, say investigators here.