In-Hospital Blood Sugar Levels Should Be Higher
Posted by: admin on: July 26, 2011
The American College of Physicians has released new guidelines recommending that doctors not attempt intensive insulin therapy designed to achieve normal blood sugar levels in patients in medical or surgical intensive care units.
- Doctors should maintain blood sugar levels between 140 and 200 milligrams per deciliter (mg/dL) for anyone in medical or surgical intensive care.
- These recommendations are similar to the guidelines from the American Diabetes Association (ADA) and the American Association of Clinical Endocrinologists (AACE). However, those guidelines recommend that blood sugar levels should be kept below 180 mg/dL to reduce the risk of infection and other complications.
- In a healthy person with type 2 diabetes, normal blood sugar levels would be between 70 mg/dL and 130 mg/dL before eating and after eating it should be under 180 mg/dL.
- High blood sugar is a common finding in hospitalized patients, and it’s associated with a lot of complications, like delayed healing, increased infection, cardiovascular events, etc
- The prevailing thought in the past was that tightly controlling the blood sugar levels would reduce inflammation, clotting and other problems. But, there are also harms that are associated with lowering the blood glucose levels too much.
Management of Hyperprolactinemia
Posted by: admin on: July 26, 2011
The Endocrine Society has released a new clinical practice guideline for the diagnosis and treatment of patients with hyperprolactinemia.
- People with high prolactin levels who have few or no symptoms and no demonstrable pituitary tumor may not need treatment, but infertile or pregnant patients, and individuals with bothersome symptoms require specialized treatment depending on the cause of their condition
- A single measurement of serum prolactin level can confirm the diagnosis if the level is above the upper limit of normal and the serum sample was obtained without excessive venipuncture stress.
- Dynamic testing of prolactin secretion is not recommended to diagnose hyperprolactinemia.
- Macroprolactin evaluation is recommended in patients with asymptomatic hyperprolactinemia.
Diagnosis and Treatment of Acute Otitis Media in Children
Posted by: admin on: July 26, 2011
- AOM is the most common condition for which antibiotics are prescribed for children however, wide variation exists in diagnosis and treatment
- Accurate diagnosis can be made by otoscopic findings of tympanic membrane bulging.
- Otoscopic findings are critical to accurate AOM diagnosis
- Antibiotics are modestly more effective than no treatment but it causes adverse effects
- Most antibiotics have comparable clinical success
Read More On http://www.medscape.org/viewarticle/732684?src=cmemp
Refer Heart Patients for Cardiac Rehab before they leave Hospital
Posted by: admin on: July 25, 2011
Mending broken hearts — the vital blood-pumping organs that have gone through surgical repairs, transplant or heart attacks — was the focus of new research released on Valentine’s Day.
- Cardiac rehab programs, reduce death rates by 25 per cent for heart patients
- Ensure that heart patients get automatically referred at the rehab as they’re leaving the hospital
- People who have had chest pain or angina could also benefit
- Rehab costs much less than a bypass surgery
- Pt, 55yrs/Male, with atrial fibrillation — an irregular heartbeat — after finding himself short of breath and unable to walk up stairs, the cardiologist referred him to a 33-session program of cardiac rehab.
- They would take pulse, blood pressure before he exercised, and all the exercises were monitored. They would keep track of his weight and he lost weight.
- He received information about getting exercise, quitting smoking, changing diet and other issues.
- People with heart conditions should talk to their doctor about getting into a cardiac rehab program
- Although in-person cardiac programs might not be available in rural areas, but home-based cardiac rehab can be beneficial.
- Patients receive an educational pamphlet and receive telephone calls at regular intervals from staff at a rehab program.
Use of Sunscreen Reduce the Risk for Invasive Melanoma
Posted by: admin on: July 25, 2011
- Investigators have identified over time 11 new primary melanomas in the population that had daily sunscreen use and 22 in those who received basically discretionary use of sunscreen.
- Perhaps more important when one looks at the risk for invasive melanomas, there were 3 invasive melanomas in the population who underwent daily sunscreen use and 11 in the control population.
- That was a hazard ratio of 0.27 indicating almost an 80% reduction in the risk for invasive melanoma.
- It was randomized, with long-term follow-up, and there’s very little question about the potential clinical relevance of a substantial reduction in the risk for invasive melanomas.
- This proves that the use of daily sunscreen in individuals who are going to be exposed to sun on a regular basis and certainly in those individuals who have a particularly high risk for the development of melanoma, such as fair skin.
Read More on http://www.medscape.com/viewarticle/736904?src=mp&spon=34
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