AFP DEPARTMENT COLLECTION

POEMs

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, 2017 Issue
Tranexamic Acid Decreased Death from Bleeding but Not All-Cause Mortality in Women with Postpartum Hemorrhage
In this really large study, tranexamic acid did not decrease the frequency of the primary outcome of death or hysterectomy in women with postpartum hemorrhage. However, there was a very small reduction in the rate of death from bleeding in the women treated with tranexamic acid.


Oct 15, 2017 Issue
Treatment of Subclinical Hypothyroidism Ineffective in Older Adults
Treatment of patients with a minimally elevated thyrotropin (thyroid-stimulating hormone) level did not result in any improvement in symptoms. If patients present with a thyrotropin level between 4.6 and 10 mIU per L, repeat the test because the levels often normalize (this occurred in 60% of the patients initially referred for the study).


Oct 15, 2017 Issue
Newer Oral Hypoglycemics Do Not Increase or Decrease Mortality
This seems like a strange question considering that the goal is to decrease mortality with drug therapy. Nevertheless, this study showed that the new kids on the diabetes block—exenatide (Byetta), dulaglutide (Trulicity), sitagliptin (Januvia), saxagliptin (Onglyza), and others—do not increase mortality, even in patients with cardiovascular risk.


Oct 1, 2017 Issue
In Very High-Risk Patients with Vascular Disease, Evolocumab Slightly Reduces Nonfatal MI But Not Mortality
In an extremely high-risk group of patients with known vascular disease, taking evolocumab instead of placebo in addition to standard statin therapy for slightly more than two years will prevent one myocardial infarction (MI) for every 83 persons treated and prevent one stroke for every 250 persons treated.


Sep 15, 2017 Issue
No Benefit with Addition of TMP/SMX to Cephalexin for Nonpurulent Cellulitis
Compared with cephalexin alone, covering for methicillin-resistant Staphylococcus aureus (MRSA) and streptococci with cephalexin plus TMP/SMX does not improve rates of clinical cure when treating nonpurulent cellulitis. However, a trend favoring the combination regimen was found in a modified intention-to-treat population in this study, so further research may be required.


Sep 15, 2017 Issue
Steroid Treatment Adds No Benefit to Antihistamines for Acute Hives
The combination approach of steroids and antihista-mines offers no added benefit to antihistamines alone for the treatment of simple urticaria.


Sep 15, 2017 Issue
Corticosteroid Injections Ineffective for Knee Osteoarthritis
This well-done study found that regular three-month intra-articular injections of triamcinolone for two years resulted in no significant difference in pain and function assessments compared with saline. However, a significant increase in cartilage loss and damage did occur in patients receiving corticosteroids compared with saline.


Sep 1, 2017 Issue
Combination of Resistance and Aerobic Exercise Best for Older Persons with Obesity
In older patients with obesity embarking on a program to improve their health, weight loss accompanied by resistance training and aerobic training resulted in the biggest gains in functional status and physical performance.


Aug 15, 2017 Issue
No Added Benefit with Higher Doses of Ketorolac for Treatment of Acute Pain in the Emergency Department
A 10-mg dose of ketorolac is as effective as higher doses for the short-term treatment of acute pain for patients in the emergency department.


Aug 15, 2017 Issue
No Increased Risk of ASD, ADHD, or SGA with First-Trimester Antidepressant Use
This study found that maternal antidepressant use during the first trimester of pregnancy is associated with an increased risk of preterm birth, but not SGA, ASD, or ADHD. Another study in the same issue also reported no increased risk of ASD with in utero exposure to selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors.


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