Internal Medicine Alert – June 30, 2010

June 30, 2010

• Diarrhea vs Death: You Decide

  Early antibiotic administration was associated with reduced likelihood of death, mechanical ventilation, and readmission (but increased risk of Clostridium difficile infection) among patients hospitalized for acute exacerbations of COPD.

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• To Drive or Not to Drive? That Is the Question

  Patients with dementia and their physicians face the difficult decision to cease driving with little solid evidence to guide them.

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• Does the Estimated GFR Cause Us to Cry Wolf with Chronic Kidney Disease?

  An analysis of more than 1 million persons in Alberta, Canada, showed that laboratory reporting of estimated glomerular filtration rate (GFR) beginning in 2004 resulted in more referrals to nephrologists, but no apparent improvement in outcomes.

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• Naproxen and Esomeprazole Delayed-Release Tablets (Vimovo®)

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• Clinical Briefs by Louis Kuritzky, MD

  In the absence of contraindications, metformin is the preferred initial treatment for most patients with type 2 diabetes (DM2). Unfortunately, monotherapy is unlikely to maintain adequate glycemic control, requiring additional treatment.

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