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FREE: Doctor Presents Overview of Current Prevention, Screening, and Management Strategies of OsteoporosisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Numerous medical studies indicate that measures for osteoporosis prevention should begin at childhood and include balanced nutrition, physical activity, and avoidance of risk factors such as smoking. In adulthood, early recognition of osteoporosis followed by timely and effective management can reduce fracture risk; however, the rates of screening and treatment for osteoporosis are surprisingly low. According to Dr. Frank Bonura, the director of Obstetrics and Gynecology at St. Catherine of Siena Medical Center, comprehensive fracture risk assessment should be part of routine patient care. Dr. Bonura explains that several ...
Source: Postgraduate Medicine Online - August 10, 2009 Category: Internal Medicine Source Type: journals

NEWS BRIEFS: Research Conveys Importance of Long-Acting Reversible ContraceptionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Emerging data from clinical studies has evidenced that the use of long-acting reversible contraception (LARC) is the most effective method of contraception with the highest continuation rates and levels of patient satisfaction. Additionally, the appropriate target population for the use of the intrauterine device now includes nulliparous women and adolescents. An article published in the July 2009 issue of Postgraduate Medicine by three doctors from Washington University in St. Louis suggests to such patients that, when initiating a new contraceptive method, one should consider the characteristics of each method, including...
Source: Postgraduate Medicine Online - August 10, 2009 Category: Internal Medicine Source Type: journals

NEWS BRIEFS: Recognition and Treatment Tips Explained for OSA and Associated DisordersEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Obstructive sleep apnea (OSA), a common and debilitating condition characterized by upper airway constriction, snoring, disturbed sleep, and excessive sleepiness, can have potentially detrimental consequences if left untreated. As most individuals affected by OSA will initially present in the primary care setting, Dr. Joseph A. Lieberman of Jefferson Medical College suggests that primary care physicians should be able to recognize the condition and thereby refer patients for any necessary treatment. His writings on the subject, featured in the latest issue of Postgraduate Medicine, focus on tips for management, interventio...
Source: Postgraduate Medicine Online - August 10, 2009 Category: Internal Medicine Source Type: journals

NEWS BRIEFS:Cause of Death in Infants of Women with Pregestational Diabetes said to have Close Relationship with Glycemic ControlEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Research has shown that, among infants of mothers with type 1 and type 2 diabetes mellitus, the rate of perinatal mortality tends to be very high. A study published by three doctors in the July 2009 issue of Postgraduate Medicine aims to identify the causes of these stillbirths, compare the rates between type 1 and type 2 diabetes sufferers, and to ascertain the relationship between perinatal mortality and maternal glycemic control. Their research indicated that congenital anomalies were less common in women with type 1 diabetes than those with type 2 diabetes. Furthermore, they conclude that hyperglycemia not only causes ...
Source: Postgraduate Medicine Online - August 10, 2009 Category: Internal Medicine Source Type: journals

FEATURE: Practice Pearl Considers Use of Glucosamine and Chondroitin Sulfate in the Management of OsteoarthritisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Research shows that osteoarthritis affects more than 20 million Americans with an anticipated increase of up to 40 million by the year 2020. The Glucosamine/Chondroitin Sulfate Osteoarthritis Intervention Trial (GAIT), originally published in the New England Journal of Medicine in 2006, evaluated the safety and efficacy of these two drugs and a combination of the two compared to use of a placebo. The authors' findings showed that joint swelling and/or effusion was reduced most significantly by chondroitin sulfate and celecoxib, and the combination of glucosamine and CS was also significant. However, the most statistically ...
Source: Postgraduate Medicine Online - August 10, 2009 Category: Internal Medicine Source Type: journals

FEATURE:Research Indicates Prescription Moderation is Necessary in Continuous Opioid Treatment for Chronic Noncancer PainEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Physicians treating chronic noncancer pain often face the discrepancy between relieving pain and suffering but also doing no harm. In this manner, many physicians have embraced the concept of long-term opioid treatment for chronic noncancer pain (CNCP), as evidenced by increased prescribing, and many patients have benefitted from these prescriptions. However, prescription opioid abuse has also risen significantly coincident with increased prescribing. Because of the potentially serious adverse effects of opioids, Drs. Stephen Colameco, Joshua Coren, and Carman Ciervo urge physicians to balance potential benefits against ri...
Source: Postgraduate Medicine Online - August 10, 2009 Category: Internal Medicine Source Type: journals

FREE: A Clear Relationship Established between HPV and Cervical CancerEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Despite cervical cancer being considered a preventable disease, it still remains the second most common malignancy in women worldwide, with a higher incidence in underdeveloped countries. Research shows that human papillomavirus (HPV) is considered to be the causative agent of cervical cancer. However, according to Drs. Deepthi Subramanya and Petros Grivas of Hahnemann University Hospital in Philadelphia, HPV infection alone is not sufficient to induce malignant transformation, and other significant cofactors contribute to the multi-step process of tumor formation, such as individual genetic variations as well as environme...
Source: Postgraduate Medicine Online - August 10, 2009 Category: Internal Medicine Source Type: journals

NEWS BRIEF: Doctor Suggests Improvements for Hyperglycemia Management in HospitalsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Although hyperglycemia is often under-recognized and suboptimally managed, it is prevalent in the inpatient setting and is associated with increased morbidity and mortality in patients with and without diabetes. Even slight improvements in hyperglycemia management in hospitalized patients can provide the hospitalist with an opportunity to positively affect morbidity, mortality, and health care costs. However, intensive insulin therapy can increase the risk of hypoglycemia, which often results in the early abandonment of tight glycemic control strategies, or in some cases, no emphasis on glucose control at all. Consequently...
Source: Postgraduate Medicine Online - August 10, 2009 Category: Internal Medicine Source Type: journals

NEWS BRIEF: Research Provides Insight into Common Chronic Metabolic Complications in HIV-Infected PatientsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Human immunodeficiency virus (HIV) infection has become a chronic illness that requires continuing medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications. Metabolic complications such as dyslipidemia, insulin resistance, diabetes mellitus, obesity, and fat distribution abnormalities are associated with increased risk of cardiovascular disease, which is now a leading cause of death among HIV-infected patients. Furthermore, many antiretroviral drugs are associated with lipid abnormalities. The management of complications such as dyslipidemia include...
Source: Postgraduate Medicine Online - August 10, 2009 Category: Internal Medicine Source Type: journals

FEATURE: Practice Pearl Comments on the Importance of HPV and Cervical Cancer VaccinesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
An article published in the July 2008 issue of Postgraduate Medicine demonstrated the importance of vaccinating patients against human papillomavirus (HPV) in order to prevent the development of cervical cancer. The authors of this study tested the quadrivalent vaccine Gardasil® and the bivalent vaccine Cervarix® to determine their efficacy in preventing infection with high-risk HPV strains in females. As a result of their research, the authors found that the new vaccines were indeed highly effecting in preventing infections and their sequelae; thus, individuals should be vaccinated prior to becoming sexually activ...
Source: Postgraduate Medicine Online - August 10, 2009 Category: Internal Medicine Source Type: journals

NEWS BRIEF: Benefits of the Gliptin Class in the Treatment of Type 2 DiabetesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Dipeptidyl peptidase-4 inhibitors (DPP-4s), or gliptins, a relatively new class of drugs for the treatment of type 2 diabetes, work in a unique way to improve insulin secretion from the β-cells of the pancreas in response to an increase in blood sugar and simultaneously decrease glucagon output from the a-cells of the pancreas and decrease hepatic glucose output. This results in a significant improvement in glucose tolerance. Since gliptins improve insulin secretion in response to an increase in blood glucose, it seems appropriate to pair them with drugs that have a different mechanism of action, such as insulin sensi...
Source: Postgraduate Medicine Online - August 10, 2009 Category: Internal Medicine Source Type: journals

ORIGINAL RESEARCH: Original Research Examines Quality of Sleep among Hypertensive PatientsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The objective of a study performed by four Nigerian researchers was to examine the quality of "poor sleep" among Nigerian hypertensive patients; specifically, to examine the association between quality of sleep and the severity of hypertension in this population. The researchers hypothesized that severity of hypertension directly influences quality of sleep, and poor quality of sleep may worsen hypertensive conditions. In the study, quality of sleep was measured using the Pittsburgh Sleep Quality Index (PSQI) in chronic hypertensive patients attending a tertiary hospital in Nigeria, and was compared with the PSQI of normal...
Source: Postgraduate Medicine Online - August 10, 2009 Category: Internal Medicine Source Type: journals

PRESS RELEASE: Study Shows Adding Liraglutide to Oral Antidiabetic Drugs Has Extra BenefitsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In a new study published in the May issue of Postgraduate Medicine entitled "Adding Liraglutide to Oral Antidiabetic Drug Monotherapy: Efficacy and Weight Benefits", scientists in Europe conducted a study to see the effect of liraglutide, a substance used for glycemic control, when used in tandem with other oral antidiabetic drugs (OADs). On their own, these drugs, which are prescribed after someone has initially been diagnosed with type 2 diabetes, often have adverse side effects, including unwanted weight gain and a higher occurrence of hypoglycemic episodes. On the other hand, liraglutide has a history of helping diabet...
Source: Postgraduate Medicine Online - July 8, 2009 Category: Internal Medicine Source Type: journals

PRESS RELEASE: Efficacy of Liraglutide in Treatment of Type 2 DiabetesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Over 180 million people worldwide suffer from diabetes mellitus and experts expect that number to double within the next 20 years. Even though many acknowledge the growing danger of diabetes, few medications effectively target the underlying cause of the disorder's progression, the deterioration of beta-cell function. Scientists searching for more effective treatments of diabetes published their most recent findings in the May issue of Postgraduate Medicine in an article named "Insights from the Liraglutide Clinical Development Program- the Liraglutide Effect and Action in Diabetes (LEAD) Studies." By using a study group o...
Source: Postgraduate Medicine Online - July 8, 2009 Category: Internal Medicine Source Type: journals

FEATURED: New SUNY Buffalo Study Examines Hypogonadotropic Hypogonadism in Men with Type 2 DiabetesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article, written by four authors from SUNY Buffalo's Division of Endocrinology, Diabetes, and Metabolism, discusses the pathophysiology, signs, and symptoms of hypogonadotropic hypogonadism. The authors report that clinical trials are required to determine whether testosterone replacement therapy alleviates insulin resistance, inflammation, and symptoms related to sexual dysfunction care. The full article can be accessed on Postgraduate Medicine's website at www.postgradmed.com.
Source: Postgraduate Medicine Online - July 8, 2009 Category: Internal Medicine Source Type: journals

FEATURED: Chronic Kidney Disease and the Proper Management of DiabetesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article, co-written by doctors Ziauddin Ahmed, Barbara Simon, and Devasmita Choudhury, discusses proper screening, identification, and management in the different stages of DKD, including special considerations for dialysis and transplant patients. The authors also review information on altered metabolism of medications and the appropriate use of diabetic agents, including recommendations for management of glucose control in CKD. The full article can be accessed on Postgraduate Medicine's website at www.postgradmed.com.
Source: Postgraduate Medicine Online - July 8, 2009 Category: Internal Medicine Source Type: journals

FREE: Therapeutic Lifestyle Strategies and Hypertension Management Developed for African AmericansEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
African Americans with high blood pressure (BP) can benefit greatly from therapeutic lifestyle changes (TLC) such as diet modification, physical activity, and weight management; however, they and their health care providers face many barriers in modifying health behaviors. A multidisciplinary panel consisting of thirteen American researchers synthesized the scientific data on TLC in African Americans for efficacy in improving BP control, barriers to behavioral change, and strategies to overcome those barriers. They assert that therapeutic lifestyle change interventions should emphasize patient self-management, supported by...
Source: Postgraduate Medicine Online - July 8, 2009 Category: Internal Medicine Source Type: journals

NEWS BRIEF: Impact of an ICU Telemedicine Program on a Rural Health Care SystemEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In a study published in the May issue of Postgraduate Medicine, six researchers from South Dakota, Texas, and New York evaluated the impact of a 15-hospital, rural, multi-state intensive care unit (ICU) telemedicine program. Acute Physiology, Age, and Chronic Health Evaluation (APACHE® III) scores, raw mortality rates, and actual-to-predicted length of stay (LOS) ratios and mortality ratios were used in research. Their surveys evaluated program impact in smaller facilities and satisfaction of the physicians staffing the remote center. Smaller facilities' staff reported improvements in the quality of critical care serv...
Source: Postgraduate Medicine Online - July 8, 2009 Category: Internal Medicine Source Type: journals

NEWS BRIEF: Puzzles in PracticeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Puzzles in Practice Encourages Doctors to Form Diagnoses Based on Case Reports A 63-year-old white man is seen for a routine examination. His medical history is significant for type 2 diabetes mellitus of 16 years duration, diabetic peripheral sensory neuropathy, hypertension, and hyperlipidemia. He smoked 1 pack of cigarettes daily for 20 years but quit many years ago. Salient findings on physical examination include decreased light touch and vibratory sense in the feet, decreased pedal pulses, and hyperpigmented patches on the lower legs. The patches have normal sensation and a hint of atrophy. There is no overlying sca...
Source: Postgraduate Medicine Online - July 8, 2009 Category: Internal Medicine Source Type: journals

NEWS BRIEF: OTC Extended-Release Formulation Said to be Effective and SafeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
It is well documented that acute bacterial respiratory infections require treatment with antibiotics, which can often be purchased over-the-counter. The original study on extended-release oral guaifenesin/pseudoephedrine aimed to assess its safety and efficacy during treatment of ten respiratory symptoms for patients in the study presenting with acute respiratory infection (ARI). The researchers concluded, and Dr. George Kikano agrees, that the drug treatment shortened the time to relief and improved respiratory symptoms better than placebo. However, says Kikano, the use of antibiotics alone may not be a sufficient approac...
Source: Postgraduate Medicine Online - July 8, 2009 Category: Internal Medicine Source Type: journals

FREE: Original Research: Study Reveals Results of Telmisartan Plus Amlodipine in Patients with Moderate or Severe HypertensionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Recent findings show that even the most advanced improvements in blood pressure control in the United States today are inadequate in relation to the prevalence of hypertension today. Patients with moderate-to-severe hypertension frequently require 2 or more antihypertensives to achieve blood pressure control. An angiotensin receptor blocker (ARB) plus a calcium channel blocker (CCB) combination seems particularly attractive for these difficult-to-control patients. A study published in the March issue of Postgraduate Medicine found that blood pressure reductions were significantly greater with combination therapies than res...
Source: Postgraduate Medicine Online - July 8, 2009 Category: Internal Medicine Source Type: journals

FREE: Improving Microvascular Outcomes in Patients with Diabetes through Management of HypertensionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
It is well known that diabetes mellitus is an independent risk factor for cardiovascular disease. In a patient with diabetes, hypertension and hyperglycemia compound and greatly increase the risk of microvascular complications. Thus, early recognition and aggressive treatment of both hyperglycemia and hypertension may prevent vision loss and chronic kidney disease, the devastating outcomes of these microvascular complications. A PubMed search was conducted by Dr. Janet B. McGill of Washington University School of Medicine to identify randomized controlled trials that evaluated hypertension control and microvascular outcome...
Source: Postgraduate Medicine Online - July 8, 2009 Category: Internal Medicine Source Type: journals

FEATURE: Gender Differences in Heart Disease Revealed in a New Study Published in Postgraduate MedicineEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In a new study published in the March issue of Postgraduate Medicine, doctors from the Department of Cardiology at the University of North Texas Medical Center investigated the different ways that cardiovascular disease, specifically coronary artery disease (CAD), presents itself in men and women. The article discusses the atypical symptoms that women with CAD exhibit, a fact that often leads doctors to underdiagnose the disease. By illuminating these sex-based distinctions, these doctors hope to help others realize the importance of critical investigation in women demonstrating these differing symptoms. The study reveals ...
Source: Postgraduate Medicine Online - July 8, 2009 Category: Internal Medicine Source Type: journals

FEATURE: Abuse and Overdose of OxyContin® Discussed in March Issue of Postgraduate MedicineEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The propensity for addiction to the pain medication OxyContin® and the recent trend of increased prescription drug abuse have made it imperative for physicians and health care providers to recognize the clinical presentation of overdose and know how to manage associated complications. In this review of OxyContin®, published in the March issue of Postgraduate Medicine, four researchers from New Jersey discuss current trends in its abuse and the clinical presentation of overdose, as well as the specific effects of the drug on body systems and the recognition of symptomatology, differential diagnosis, and management...
Source: Postgraduate Medicine Online - July 8, 2009 Category: Internal Medicine Source Type: journals

NEWS BRIEF: Major Trials in Cardiovascular Disease Evaluate New Agents in the Treatment of MIEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
An article published by three doctors from the Ochsner Medical Center in New Orleans provides information and commentary on recent clinical trials related to primary prevention in cardiovascular diseases including lipids, hypertension, and diabetes. It also focuses on novel therapeutic advances in heart failure with devices and therapeutic agents. In addition, the researchers explore trials looking at the effects of the investigational agents azimilide and dronedarone in the treatment of arrhythmias, application of established therapies and devices to larger populations, and the impact of hypercoagulability and aortic arch...
Source: Postgraduate Medicine Online - July 8, 2009 Category: Internal Medicine Source Type: journals

NEWS BRIEF: A Case Report on Escherichia coli Septic Shock Provides Answers to Heart Attack MysteriesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Myocardial dysfunction is a well-known entity in patients presenting with severe sepsis and can be easily recognized by the release of troponin or by echocardiographic findings. Three researchers from Galveston, Texas, present a case of a 59-year-old woman with ST-segment elevations and increased levels of cardiac troponin from Escherichia coli septic shock in the setting of normal coronary angiography in the March issue of Postgraduate Medicine. The case report indicates that elevated cardiac biomarkers in conjunction with electrocardiographic changes are valuable in diagnosing acute coronary syndrome (ACS). Furthermore, ...
Source: Postgraduate Medicine Online - July 8, 2009 Category: Internal Medicine Source Type: journals

NEWS BRIEF: Patients with HIV and Cryptococcosis in America Decreasing While Hospital Admissions Remain SteadyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A study published in the March issue of Postgraduate Medicine compiled and examined data about HIV-positive patients admitted to the hospital with cryptococcosis, a potentially fatal fungal disease. In the article, doctors reviewed the records of 202 HIV-positive patients who were admitted to both the University of Maryland Medical Center and the Baltimore VA Medical Center for a case of primary cryptococcosis from 1993 to 2004. The study found that although the prevalence of cryptococcosis in the United States is decreasing, the number of HIV-positive patients admitted to these two hospitals did not decline during this pe...
Source: Postgraduate Medicine Online - July 8, 2009 Category: Internal Medicine Source Type: journals