Clinical Briefs in Primary Care – July 1, 2015

July 1, 2015

• Can You Make ‘Flat’ Basal Insulin ‘Flatter?’

  For patients incurring problematic episodes of hypoglycemia, an insulin that provides even “flatter” plasma levels may provide an advantage.

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• Left Atrial Appendage Closure: Another Possible Interventional Fix for Atrial Fibrillation

  Left atrial appendage closure may be another reasonable option for reduction of stroke risk in atrial fibrillation.

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• A Glimmer of Hope for Beta-Blockers in Heart Failure from Diastolic Dysfunction

  Because these data are observational in nature, they cannot definitively establish whether beta-blocker treatment reduces mortality in d-CHF, but they provide strong impetus to perform a large randomized trial to ultimately answer the question.

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• Delay in Diagnosis of Hepatocellular Carcinoma

  Diagnostic delays are common among patients with hepatocellular carcinoma.

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• Initial Orthostatic Hypotension: An Under-Recognized Form of Orthostatic Hypotension

  Initial orthostatic hypotension represents a population at risk for falls, which may be missed with traditional methods of orthostatic BP measurement.

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• Beta-blocker, Shmeta-blocker…Or Are There Important Differences?

  Whether clinicians should choose pharmacotherapy based on central BP effects has not been confirmed, although hypertension guidelines throughout the world have increasingly recognized the inadequacy of traditional beta-blockers in comparison to most other classes of agents and relegated them to a lower position on the therapeutic ladder.

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