More articles from 1-Minute Consult
- Should all patients with acute pericarditis be treated with colchicine?
Colchicine should be considered a first-line treatment for acute pericarditis and for preventing recurrent episodes.
- At what age should we discontinue colon cancer screening in the elderly?
In general, you should stop when you do not expect the patient to live 7 to 10 more years. However, the full answer is more complicated.
- Which agents should we use to treat and prevent influenza in 2006–2007?
Oseltamivir (Tamiflu) and zanamivir (Relenza) are the treatments of choice this year, but vaccination remains the primary preventive measure.
- When can patients with acute deep vein thrombosis be allowed to get up and walk?
They should ambulate as tolerated. Bed rest is not evidence-based and may be harmful.
- When should prophylactic anticoagulation begin after a hip fracture?
The short answer is immediately, but several issues need consideration before starting.
- How often should patients with hepatitis C be screened for esophageal varices?
If the patient has cirrhosis, screen promptly with upper endoscopy. If no varices are found, repeat endoscopy every 2 years.
- Should beta-blockers be discontinued when a patient is admitted to the hospital with acutely decompensated heart failure?
Hard data on this topic are scant, but the answer depends on the patient’s perfusion status and vital signs.
- How should we advise patients about the contraceptive patch, given the FDA warning?
In theory, patients could face a higher risk of thromboembolism than with oral contraceptives. But most of all we want to urge them not to simply stop using contraception.
- What is osteopenia, and what should be done about it?
Because the term “osteopenia” is not useful as a diagnosis and can actually be harmful, I am on a personal crusade to eliminate it from the bone density lexicon.
- How long can my patient use intranasal steroid sprays?
There is little evidence to indicate they cause significant systemic side effects. However, patients who use them regularly should undergo examinations of the nasal cavity at least once a year to check for damage to the septum.