Clinical Briefs in Primary Care
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The Ever-elusive Prescription for the Optimum Diet
Somewhat contrary to the prevailing wisdom, intake of total fat was inversely associated with total mortality. Even the much-maligned saturated fat in the diet was associated with a reduced hazard ratio for total mortality.
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Diuretic Use in Heart Failure
For diuretic resistance, the authors endorsed continuous diuretic infusion with stepwise dose increases to achieve a 3-5 liter/day urine volume until euvolemia is achieved.
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When Gastrointestinal Complaints Are Not Prominent
In a review of patients with biopsy-proven celiac disease, those who presented with gastrointestinal symptoms exhibited a median time to diagnosis of 2.3 months, compared to 42 months for those without gastrointestinal symptoms.
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Sexual Dysfunction Among Diabetics
In a review of diabetic men and diabetic women, evaluations of sexual quality of life in both genders was meaningfully affected by partner sexual dysfunction. Perhaps not surprisingly, age and duration of diabetes were the strongest predictors of sexual dysfunction in diabetic men. The authors opined that insufficient attention has been given to the presence and effect of sexual dysfunction on the quality of life of patients and their partners.
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Considering Systemic Treatment for Atopic Dermatitis
A recent panel of eczema experts convened to provide advice about when clinicians should consider systemic treatment.
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Cardiorespiratory Fitness and Mortality
In both men and women in the United States, levels of cardiorespiratory fitness are inversely related to mortality. An encouraging epidemiologic study of women found that even brisk walking for about 30 minutes daily was associated with near maximal cardiovascular health benefits.
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Searching for Answers on Knee Osteoarthritis
Data consistently show that for knee osteoarthritis, weight loss is associated with symptomatic and functional improvement. The mechanism of this is incompletely understood, since weight loss has not been shown to affect the progressive degradation of cartilage typical of osteoarthritis.
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New Pharmacologic Direction for Parkinson’s Disease
Most clinicians are used to thinking about dopamine modulation when considering treatments for Parkinson’s disease. Unfortunately, none of the current treatments can be designated as disease-modifying, even though such treatment provides transient symptomatic relief.
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Morphine in Dyspneic Acute Heart Failure
Based on recent data, clinicians should avoid morphine use in acute heart failure patients.
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CV Benefits of GLP-1RA Treatment in Type 2 Diabetes
Among the sodium-glucose cotransporter 2 inhibitor and glucagon-like peptide-1 receptor agonist classes of pharmacotherapy, there appears to be much more similarity than not. Should clinicians consider these salubrious cardiovascular effects a class effect? That is, should all members of the class be anticipated to experience similarly favorable cardiovascular outcomes?