Q&A

A polyphenol-enriched diet with 50% carbohydrate restriction and low iron availability was superior to a conventional protein-restricted diet in slowing the progression of diabetic nephropathy.

These findings must be confirmed by additional high-quality studies before physicians can routinely recommend a change from the conventional low-protein diet. Current use of this diet is limited, as many nutritionists— even those specializing in diabetes—have no knowledge of it.

A polyphenol-enriched diet with 50% carbohydrate restriction and low iron availability was superior to a conventional protein-restricted diet in slowing the progression of diabetic nephropathy.

These findings must be confirmed by additional high-quality studies before physicians can routinely recommend a change from the conventional low-protein diet. Current use of this diet is limited, as many nutritionists— even those specializing in diabetes—have no knowledge of it.

A polyphenol-enriched diet with 50% carbohydrate restriction and low iron availability was superior to a conventional protein-restricted diet in slowing the progression of diabetic nephropathy.

These findings must be confirmed by additional high-quality studies before physicians can routinely recommend a change from the conventional low-protein diet. Current use of this diet is limited, as many nutritionists— even those specializing in diabetes—have no knowledge of it.

Ezetimibe plus atorvastatin lowers low-density lipoprotein (LDL) cholesterol more than either alone. When combined with low-dose atorvastatin (10 mg), ezetimibe achieves reductions similar to those seen with atorvastatin (80 mg) alone in LDL cholesterol, the ratio of total cholesterol to high-density lipoprotein (HDL) cholesterol, and triglycerides.

Despite these modest reductions in cholesterol, this study does not provide evidence that this combination lessens cardiovascular morbidity or mortality. With this caveat, adding ezetimibe to atorvastatin may be a reasonable alternative for patients already on high-dose atorvastatin who either can’t reach target cholesterol levels or experience significant side effects.

Ezetimibe plus atorvastatin lowers low-density lipoprotein (LDL) cholesterol more than either alone. When combined with low-dose atorvastatin (10 mg), ezetimibe achieves reductions similar to those seen with atorvastatin (80 mg) alone in LDL cholesterol, the ratio of total cholesterol to high-density lipoprotein (HDL) cholesterol, and triglycerides.

Despite these modest reductions in cholesterol, this study does not provide evidence that this combination lessens cardiovascular morbidity or mortality. With this caveat, adding ezetimibe to atorvastatin may be a reasonable alternative for patients already on high-dose atorvastatin who either can’t reach target cholesterol levels or experience significant side effects.

Ezetimibe plus atorvastatin lowers low-density lipoprotein (LDL) cholesterol more than either alone. When combined with low-dose atorvastatin (10 mg), ezetimibe achieves reductions similar to those seen with atorvastatin (80 mg) alone in LDL cholesterol, the ratio of total cholesterol to high-density lipoprotein (HDL) cholesterol, and triglycerides.

Despite these modest reductions in cholesterol, this study does not provide evidence that this combination lessens cardiovascular morbidity or mortality. With this caveat, adding ezetimibe to atorvastatin may be a reasonable alternative for patients already on high-dose atorvastatin who either can’t reach target cholesterol levels or experience significant side effects.

A significant proportion of prostate-specific antigen (PSA) tests with abnormal results— nearly half—normalize over 1 to 4 years of follow-up without any medical or surgical intervention. This information can be used by physicians and their patients in shared decision-making about both PSA screening and in deciding how to follow up an abnormal result.

A significant proportion of prostate-specific antigen (PSA) tests with abnormal results— nearly half—normalize over 1 to 4 years of follow-up without any medical or surgical intervention. This information can be used by physicians and their patients in shared decision-making about both PSA screening and in deciding how to follow up an abnormal result.

A significant proportion of prostate-specific antigen (PSA) tests with abnormal results— nearly half—normalize over 1 to 4 years of follow-up without any medical or surgical intervention. This information can be used by physicians and their patients in shared decision-making about both PSA screening and in deciding how to follow up an abnormal result.

Treatment with omeprazole relieved symptoms in the first 2 weeks in about half of patients with dyspepsia—a better response than in the patients treated with placebo. However, by 6 weeks a similar number of patients taking placebo also had symptoms relieved, and at 1 year treatment offered no benefit over placebo.

Additionally, treatment (vs placebo) did not reduce the number of patients who eventually would need endoscopy to investigate the cause of their dyspepsia. Interestingly, treating patients first with either placebo or omeprazole reduced the need for endoscopy by almost half.

Treatment with omeprazole relieved symptoms in the first 2 weeks in about half of patients with dyspepsia—a better response than in the patients treated with placebo. However, by 6 weeks a similar number of patients taking placebo also had symptoms relieved, and at 1 year treatment offered no benefit over placebo.

Additionally, treatment (vs placebo) did not reduce the number of patients who eventually would need endoscopy to investigate the cause of their dyspepsia. Interestingly, treating patients first with either placebo or omeprazole reduced the need for endoscopy by almost half.

Treatment with omeprazole relieved symptoms in the first 2 weeks in about half of patients with dyspepsia—a better response than in the patients treated with placebo. However, by 6 weeks a similar number of patients taking placebo also had symptoms relieved, and at 1 year treatment offered no benefit over placebo.

Additionally, treatment (vs placebo) did not reduce the number of patients who eventually would need endoscopy to investigate the cause of their dyspepsia. Interestingly, treating patients first with either placebo or omeprazole reduced the need for endoscopy by almost half.

Low-dose diuretics are equal or superior to all other major classes of antihypertensive medications in improving long-term cardiovascular outcomes. Given that diuretics are also inexpensive and have a favorable side-effect profile, clinicians should use low-dose diuretics (eg, hydrochlorothiazide 25 mg/d or less) as a first choice for almost all patients with hypertension.

Clinicians should keep in mind that many patients require more than 1 medication. They should look for further information from pooled studies regarding specific populations such as those with diabetes or chronic renal disease, the elderly, or persons of color.

Low-dose diuretics are equal or superior to all other major classes of antihypertensive medications in improving long-term cardiovascular outcomes. Given that diuretics are also inexpensive and have a favorable side-effect profile, clinicians should use low-dose diuretics (eg, hydrochlorothiazide 25 mg/d or less) as a first choice for almost all patients with hypertension.

Clinicians should keep in mind that many patients require more than 1 medication. They should look for further information from pooled studies regarding specific populations such as those with diabetes or chronic renal disease, the elderly, or persons of color.

Low-dose diuretics are equal or superior to all other major classes of antihypertensive medications in improving long-term cardiovascular outcomes. Given that diuretics are also inexpensive and have a favorable side-effect profile, clinicians should use low-dose diuretics (eg, hydrochlorothiazide 25 mg/d or less) as a first choice for almost all patients with hypertension.

Clinicians should keep in mind that many patients require more than 1 medication. They should look for further information from pooled studies regarding specific populations such as those with diabetes or chronic renal disease, the elderly, or persons of color.

This study provides good evidence that continuous use of combination oral contraceptives for 1 year decreases bleeding without clinically important changes in blood pressure, weight, or hemoglobin when compared with cyclic users. Clinicians should consider offering this option to their patients, while continuing to look for evidence that addresses long-term sequelae, as well as patients of color or those with less than a college education.

This study provides good evidence that continuous use of combination oral contraceptives for 1 year decreases bleeding without clinically important changes in blood pressure, weight, or hemoglobin when compared with cyclic users. Clinicians should consider offering this option to their patients, while continuing to look for evidence that addresses long-term sequelae, as well as patients of color or those with less than a college education.

This study provides good evidence that continuous use of combination oral contraceptives for 1 year decreases bleeding without clinically important changes in blood pressure, weight, or hemoglobin when compared with cyclic users. Clinicians should consider offering this option to their patients, while continuing to look for evidence that addresses long-term sequelae, as well as patients of color or those with less than a college education.

Zonisamide (Zonegran), in conjunction with a reduced-calorie diet (deficit of 500 kcal/d), resulted in an additional mean 5-kg (11-pound) weight loss compared with diet alone. This regimen was well-tolerated in obese female patients. Further evaluation of long-term side effects and continued weight loss beyond 32 weeks is needed.

Zonisamide (Zonegran), in conjunction with a reduced-calorie diet (deficit of 500 kcal/d), resulted in an additional mean 5-kg (11-pound) weight loss compared with diet alone. This regimen was well-tolerated in obese female patients. Further evaluation of long-term side effects and continued weight loss beyond 32 weeks is needed.

Zonisamide (Zonegran), in conjunction with a reduced-calorie diet (deficit of 500 kcal/d), resulted in an additional mean 5-kg (11-pound) weight loss compared with diet alone. This regimen was well-tolerated in obese female patients. Further evaluation of long-term side effects and continued weight loss beyond 32 weeks is needed.

Blood cultures rarely contribute to the management of uncomplicated community-acquired pneumonia. A positive blood culture has no relation to the severity of the illness or to patient outcomes. Physicians should order blood cultures only for those patients with severe illness and for those in whom initial therapy fails.

Blood cultures rarely contribute to the management of uncomplicated community-acquired pneumonia. A positive blood culture has no relation to the severity of the illness or to patient outcomes. Physicians should order blood cultures only for those patients with severe illness and for those in whom initial therapy fails.

Blood cultures rarely contribute to the management of uncomplicated community-acquired pneumonia. A positive blood culture has no relation to the severity of the illness or to patient outcomes. Physicians should order blood cultures only for those patients with severe illness and for those in whom initial therapy fails.

Eplerenone, a selective mineralocorticoid receptor antagonist currently approved by the Food and Drug Administration for treatment of hypertension, reduces mortality following myocardial infarction (MI) in patients with left ventricular dysfunction and clinical signs of congestive heart failure. Previous research by the same group established that spironolactone does the same at lower cost than eplenerone.¹

Eplerenone, a selective mineralocorticoid receptor antagonist currently approved by the Food and Drug Administration for treatment of hypertension, reduces mortality following myocardial infarction (MI) in patients with left ventricular dysfunction and clinical signs of congestive heart failure. Previous research by the same group established that spironolactone does the same at lower cost than eplenerone.¹

Eplerenone, a selective mineralocorticoid receptor antagonist currently approved by the Food and Drug Administration for treatment of hypertension, reduces mortality following myocardial infarction (MI) in patients with left ventricular dysfunction and clinical signs of congestive heart failure. Previous research by the same group established that spironolactone does the same at lower cost than eplenerone.¹