Internal Medicine Alert 2007-12-30

'Tis the Season

Neither antibiotics nor nasal steroids nor the combination of the two reduces the duration of acute sinusitis symptoms compared with placebo.

Use of Proton Pump Inhibitors and Other Acid Suppressive Medications in Newly Admitted Nursing Facility Patients

Many nursing home patients are admitted with prescriptions for proton pump inhibitors or H2-receptor antagonists without any obvious indication.

Intravenous Bisphosphonate and Facial Bones

IV bisphosphonate treatment is associated with an increased risk of inflammation in the bones of the jaw and face.

Diagnosing Early Pancreatic Cancer

Although pancreatic cancer growth is considered rapid, early recognition of resectable disease remains the best chance for long-term survival. It is possible that an early sign of evolving pancreatic neoplasm is glucose intolerance. In a series of 30 pancreatic cancer patients evaluated at the Mayo Clinic, CT scans obtained 6 months or more before the diagnosis revealed potentially resectable lesions in some, and this was notably true for those who had CT scans and new-onset diabetes several months before the diagnosis of pancreatic cancer. Thus, physicians evaluating adults with newly diagnosed diabetes should consider the possibility that the glucose intolerance is an accompaniment of early pancreatic neoplasia.

Sorafenib Tablets(Nexavar®)

Sorafenib has been approved by the FDA forthe treatment of inoperable hepatocellular cancer. It is an oral multikinase inhibitor that was previously approved for advanced renal cell carcinoma. It is manufactured by Bayer HealthCare AG in Germany and marketed by Bayer Pharmaceuticals Corporation as Nexavar.

Clinical Briefs by Louis Kuritzky, MD

Incidentalomas:It's All In Your Head, Skin Cancer Screening: Our Patients Want It!, and Bell's Palsy: Steroids, Acyclovir, Both, or Neither?

Internal Medicine Alert – December 30, 2007

December 30, 2007