Clinical Briefs in Primary Care – January 1, 2018
January 1, 2018
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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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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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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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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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Dealing With Severe Acute Pain in the ED
The success of a non-opioid treatment arm in direct comparison with three opioid treatment arms should justify greater consideration of non-opioid treatment for acute severe pain.
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Reducing Falls Among Older Adults
Exercise, correction of impaired vision, supplemental calcium/vitamin D, and environmental interventions reduce falls. Interventions that are multimodal appear to produce additive benefits.