POEMs (Patient-Oriented Evidence that Matters) are summaries of research that is relevant to physicians and their patients and meet three criteria: address a question that primary care physicians face in day-to-day practice; measure outcomes important to physicians and patients, including symptoms, morbidity, quality of life, and mortality; and have the potential to change the way physicians practice.

Oct 15, 2016 Issue
Third-Generation Oral Contraceptives Associated with Greater Risk of PE, Stroke, and MI
Although there is risk with any current oral contraceptive combination, those that contain lower doses of estrogen, and levonorgestrel instead of desogestrel or gestodene, are associated with the least risk of ischemic stroke, myocardial infarction (MI), or pulmonary embolism (PE). These safer products are older so are often less expensive.

Oct 15, 2016 Issue
All Analgesics Are Better Than Placebo in Patients with Knee or Hip DJD
In patients with hip or knee DJD, all analgesics are more effective than placebo in relieving pain and improving function. Although paracetamol (acetaminophen) is the least effective of all the drugs studied, it still may be the first treatment for these patients because of its safety profile.

Oct 15, 2016 Issue
Low-Dose Morphine Less Effective Than Diclofenac or Acetaminophen for Renal Colic
This is a good example of how a well-done study can lead to erroneous conclusions. The comparator most likely to be effective here—titrated morphine—was used at a low dose and found to be less effective than intramuscular diclofenac or intravenous paracetamol (acetaminophen).

Oct 15, 2016 Issue
Procalcitonin Guidance Safely Decreases Antibiotic Use in Critically Ill Patients
For patients in the intensive care unit (ICU) who receive antibiotics for presumed or proven bacterial infections, the use of procalcitonin levels to determine when to stop antibiotic therapy results in decreased duration and consumption of antibiotics without increasing mortality.

Sep 1, 2016 Issue
Flibanserin Ineffective for Hypoactive Sexual Desire Disorder in Women
Flibanserin produces a minimal effect on sexual desire and minimally increases the number of satisfying sexual events in women (less than one-half an event per month increase). Many women will be unable to tolerate the adverse effects.

Sep 1, 2016 Issue
Inhaled Fluticasone-Salmeterol Better Than Fluticasone Alone for Moderate to Severe Asthma
The combination of fluticasone and salmeterol (Advair), with the steroid dose adjusted for disease severity, reduces the number of severe asthma exacerbations more than fluticasone (Flovent) alone (number needed to treat [NNT] = 50 over 26 weeks), with no difference in terms of potential harms, such as intubation or asthma-related death.

Sep 1, 2016 Issue
CBT Effective in Adolescents with Depression Who Do Not Want Medication
In adolescents who eschew drug treatment of major depression, short-term CBT is more effective than treatment as usual in inducing recovery, with a number needed to treat of 4 to 10. CBT also produced faster results.

Sep 1, 2016 Issue
Newer Sulfonylureas Not Associated with Increased Mortality, MIs, or Strokes
In multiple randomized trials, the long-term use of second- or third-generation sulfonylureas in patients with type 2 diabetes is not associated with more deaths, myocardial infarctions (MIs), or strokes. The included trials tended not to report other safety data.

Aug 15, 2016 Issue
Single-Dose Dexamethasone Equals Three Days of Steroids in Children with Acute Asthma
In addition to usual beta-agonist treatment, a single dose of oral dexamethasone is as effective as three days of prednisolone (with less vomiting) in decreasing respiratory symptoms without increasing hospitalizations, follow-up visits, and days lost from school. Additional treatment with a steroid was more common in the group receiving the single dose of dexamethasone.

Aug 15, 2016 Issue
Knee Surgery Does Not Reduce Knee Catching or Locking in Patients with Meniscal Tear
Removing the torn bits of meniscus in middle-aged patients who have intermittent knee catches or locking does not decrease their likelihood of experiencing symptoms in the following year compared with diagnostic arthroscopy (i.e., looking but not touching). In general, meniscectomy does not improve knee pain, regardless of the symptoms.

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