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Clinical Briefs in Primary Care – November 1, 2017

November 1, 2017

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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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.