Clinical Briefs in Primary Care
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A Link Between Demodex Mites and Rosacea
The role of Demodex in rosacea appears to be well demonstrated. Since eradication of Demodex is insufficient to resolve rosacea, other pathophysiologic pathways also must be involved.
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More Good News for GLP-1 RA in Type 2 Diabetes
Since 2008, the FDA has required all new diabetes medications to provide evidence of cardiovascular (CV) safety. The good news is that several classes of agents have demonstrated not only CV safety, but even efficacy in reducing CV events and (in some cases) all-cause mortality.
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Menopausal Hormone Replacement
For women who use or have used hormone replacement for menopausal symptoms, new data should be reassuring that their symptom relief does not come at a cost of increased total or cancer-related mortality.
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Is It Safe to Use PPIs Long Term?
Proton pump inhibitors (PPIs) are among the most widely used medications in the United States, thanks to a generally favorable combination of efficacy, tolerability, and safety. Because such a large portion of the adult population uses PPIs, even if a small fraction experiences an adverse effect, it becomes a potentially important issue.
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The Long-term Picture After Bariatric Surgery
While often viewed as a last-resort treatment of obesity, bariatric surgery actually is the only intervention demonstrated to improve obesity-related mortality. Strict criteria for payment by insurers and costs that are inaccessible to most of the uninsured have restricted the population who could benefit from bariatric surgery.
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Opioid-induced Nausea and Vomiting
Opioids are highly effective when administered for appropriate indications. Unfortunately, opioid-induced nausea and/or vomiting (OINV) can limit opioid effectiveness. In the immediate postoperative period, OINV can stress wound integrity and prolong hospital stay. In the outpatient setting, some patients are faced with the dilemma of accepting lesser levels of pain control in exchange for less OINV as they consider whether they should decrease their opioid dosing schedule.
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Separating Celiac Disease From Non-celiac Gluten Sensitivity
As there is no diagnostic test to confirm any patient’s 'non-gluten celiac sensitivity,' debate on the issue continues.
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Azithromycin Reduces Asthma Exacerbations
Asthma exacerbations essentially are induced exclusively by viral infections (as well as thermal and atopic stimuli). Is it time to reconsider that posture?
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BCG Vaccinations and the False-positive Effect
Clinicians should consider that the bacille Calmette-Guerin vaccination effect could influence tuberculin testing responsivity for an essentially indefinite period.
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Measuring Urine Calcium in Nephrolithiasis Patients
High sodium content in the diet increases calcium excretion in the urine, so sodium restriction may be beneficial. Thiazide diuretics reduce urinary calcium excretion and are useful when dietary and hydration steps are insufficient.