Editor’s Note - December 2015

Volume 55 - Issue 12 - December 2015

Case 1: A 19-year-old man with mild asthma was recently intubated during what he described as a “serious asthma attack.” Given his mild asthma, how could he have experienced such a near-fatal attack?1 

Case 2: A 56-year-old woman grew up hearing that 3 glasses of milk a day is good for her bones. Now that she is concerned about osteoporosis, should she add this to her diet?2 

If these scenarios sound familiar, check out Consultant360’s twice-weekly clinical pearls of wisdom. On Tuesdays, a nutrition-focused pearl focuses on hot topics derived from the recent literature, such as personal portion size, spicy food and all-cause mortality, saturated fat, and the Mediterranean diet. On Thursdays, the practical pointers highlight studies that may not have gotten traction within the clinical community and/or may have been overlooked since their time of publishing but warrant a second look. 

Here is a look at some of Consultant360’s recent pearls:

• What is a normal portion size? A 30-year-old overweight man struggles to lose weight and inquires about normal serving sizes. Answer: Patients’ individual weight influences their interpretation of a normal serving size.3

• How do you manage warfarin during dental surgery? A 72-year-old man who has been taking warfarin for 3 years because of atrial fibrillation is undergoing 2 dental extractions, and his dentist asked that you manage his warfarin for the procedure. What do you do? Answer: Continue warfarin and add a topical prohemostatic agent.4

• Can any ingredients be added to meals for better health? A 32-year-old overweight man is starting to cook dinners rather than eat out and wonders if there are any ingredients he should add to his cooking. Answer: Spicy foods, particularly those seasoned with chili peppers, can help reduce all-cause mortality.5

• Can a drug test unexpectedly be positive for methadone without use? A 56-year-old man fell off a ladder and was prescribed tramadol for pain relief. A urine test came back positive for methadone, which the patient denied using. Is that possible? Answer: The quetiapine that he takes for depression is causing a false positive for methadone.6

Our weekly pearls are only available at Consultant360.com. And while you are there, sign up for our daily e-newsletters and have breaking news, including our weekly pearls, delivered directly to your inbox.

Sincerely,

Pooja Shah

Editor, Consultant and Consultant360. 

References:

  1. Kuritzky L. Pearls of wisdom: Near-fatal asthma attacks. Consultant360. November 18, 2015. www.consultant360.com/exclusives/pearls-wisdom-near-fatal-asthma-attacks. Accessed November 30, 2015.
  2. Harlan T. Nutritional pearls: Is drinking milk good for your bones? Consultant360. November 11, 2015. www.consultant360.com/exclusives/nutritional-pearls-drinking-milk-good-your-bones. Accessed November 30, 2015.
  3. Harlan T. Nutritional pearls: Personal portion sizes. Consultant360. November 24, 2015. www.consultant360.com/exclusives/nutritional-pearls-personal-portion-sizes. Accessed November 30, 2015.
  4. Kuritzky L. Pearls of wisdom: Warfarin management with dental surgery. Consultant360. November 5, 2015. www.consultant360.com/exclusives/pearls-wisdom-warfarin-management-dental-surgery. Accessed November 30, 2015.
  5. Harlan T. Nutritional pearls: Could eating spicy food reduce all-cause mortality? Consultant360. October 20, 2015. www.consultant360.com/exclusives/nutritional-pearls-could-eating-spicy-food-reduce-all-cause-mortality. Accessed November 30, 2015.
  6. Kuritzky L. Pearls of wisdom: A drug test unexpectedly positive for methadone. Consultant360. October 29, 2015. www.consultant360.com/exclusives/pearls-wisdom-drug-test-unexpectedly-positive-methadone. Accessed November 30, 2015.