Clinical Briefs in Primary Care
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Carbon Monoxide Toxicity in the Elderly
Hyperbaric oxygen treatment is generally considered the optimum treatment resource for carbon monoxide toxicity, although a Cochrane review did not confirm the superiority of hyperbaric oxygen over treatment with normobaric oxygen.
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Roflumilast for Acute Exacerbations in COPD
Acute exacerbations of COPD are potentially highly consequential: in-hospital mortality is approximately 10%, and up to 25% of patients admitted to the ICU die.
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Clindamycin vs TMP-SMX for Skin Infections
The treatment of cellulitis, with or without a local abscess, has become more complicated since MRSA has assumed the causal role of “guilty until proven otherwise” in such settings.
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Ongoing Saga of Homocysteine and Vasculopathy
The relationship between homocysteine and vascular disease has been recognized for at least two decades. Indeed, the strength of the association between plasma hCYS levels and coronary atherosclerosis surpasses that of cholesterol.
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Treatment of OSA Reduces Risk of Repeat Revascularization After PCI
Obstructive sleep apnea is associated with numerous comorbidities and downstream consequences, not the least of which are increased cardiovascular events, hypertension, and arrhythmias.
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Difficult Questions About Testosterone and Mortality
The number of men receiving treatment for hypogonadism has increased dramatically over the past decade. At the same time, some clinical trials have suggested that there are safety issues with testosterone.
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Psoriasis Is Associated with Insulin Resistance
The pathophysiology of psoriasis has much in common with rheumatoid arthritis.
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Consequences of NSAID Use in Patients Receiving Post-MI Antithrombotic Prophylaxis
Most patients receive antiplatelet treatment after an acute coronary syndrome. Combinations of antiplatelet agents reduce risk of recurrent MI — particularly stent thrombosis — but do have a modest increase in bleeding risk. Well, what about our post-MI patients who are taking appropriately prescribed antiplatelet agents who also require treatment with NSAIDs for disorders like osteoarthritis, migraine, etc? How does such multidrug co-administration affect risks?
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Might Long-term Dual Antiplatelet Therapy Be Better? Not
Risk reduction provided by dual antiplatelet therapy (DAT) in the short-term interval (3-12 months) after coronary stenting is well established, and published guidelines provide consistent advice about appropriate duration of such therapy.
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Dual Add-on Therapy for Type 2 Diabetes When Metformin is Not Enough
The current (2015) American Diabetes Association guidance for progression of treatment when A1c goals are not attained with metformin implies stepwise initiation of additional monotherapies.