The Medical clinics of North America
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Maintaining optimal health and well-being in the older adult requires understanding of how physiologic changes influence nutritional status, familiarity with the available validated tools to assess status, identification of factors predisposing older adults to malnutrition, and evidence-based practice regarding the nutritional needs of this age group. Evidence-based guidance on these core practice components is provided to the clinician in this article.
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Med. Clin. North Am. · Sep 2016
ReviewEvidence-based Recommendations for the Evaluation of Palpitations in the Primary Care Setting.
Palpitations are a symptom of many cardiac and noncardiac conditions. The patient's history, physical examination, appropriately directed laboratory tests, and basic electrocardiogram are helpful in evaluating palpitations and may be essential to finding a diagnosis. ⋯ These evaluation tools include Holter monitor, event monitor, transtelephonic electrocardiographic monitor, treadmill exercise stress test, echocardiography, and electrophysiologic studies. Most patients can be evaluated as an outpatient, but there are reasons, such as hemodynamic compromise, that may require admission to an inpatient setting to complete the diagnostic workup.
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Headaches remain one of the most common reasons for patients to seek acute care. It is important to assess whether the headache meets criteria for a primary (uncomplicated) versus a secondary headache, due to an underlying condition. ⋯ This will help determine if imaging studies are warranted. Management of uncomplicated headache should include treatment of the acute headache and an action plan for reducing the frequency and severity of future headaches.
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Med. Clin. North Am. · Sep 2016
ReviewUtilization and Safety of Common Over-the-Counter Dietary/Nutritional Supplements, Herbal Agents, and Homeopathic Compounds for Disease Prevention.
Dietary supplements are commonly used by patients as part of their medical care plan. Often clinicians may not be aware of their use, because patients do not always consider these to be medications. ⋯ These interactions may lead to severe adverse reactions. This article reviews available evidence for a variety of dietary supplements in select disease categories.
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Type 2 diabetes (T2DM) is a common condition. Treatment of diabetes and related complications can be complex. ⋯ Medical spending attributed to diabetes per individual is significant. With appropriate therapy, patients can lead full, healthy lives with the disease, so making informed decisions regarding pharmacotherapy for T2DM is clearly of great importance.