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.

Mar 15, 2017 Issue
Detrimental Effect of Tight Glucose Control on CV Mortality Persists Over Nine Years
The initial Action to Control Cardiovascular Risk in Diabetes (ACCORD) study, which compared standard treatment with intensive control, found that despite good intentions, cardiovascular (CV) and overall mortality are significantly higher when blood glucose levels are lower.


Mar 15, 2017 Issue
Single-Dose Dexamethasone an Option for Acute Adult Asthma
A single dose of 12-mg dexamethasone, which has a longer duration of action than prednisone, is almost as effective as five days of 60-mg prednisone for the prevention of relapse in adults with acute asthma treated in an emergency department.


Mar 15, 2017 Issue
Semaglutide Reduces CV Events in High-Risk Patients with Type 2 Diabetes Mellitus
Semaglutide significantly reduced the composite outcome of CV death, nonfatal myocardial infarction, and nonfatal stroke (number needed to treat [NNT] = 43 over 2.1 years). It was generally well tolerated, and it reduced body weight by approximately 6.4 to 9.5 lb (2.9 to 4.3 kg).


Mar 15, 2017 Issue
Antipsychotics Worsen Symptoms in Patients with Delirium Who Receive Palliative Care
For hospitalized patients with acute delirium and symptoms of distress who are receiving palliative care, the use of risperidone (Risperdal) or haloperidol at conservative oral doses worsens symptoms and may shorten overall survival.


Feb 15, 2017 Issue
Steroids at 34 to 36 Weeks’ and Before Term Cesarean Decrease Respiratory Distress Syndrome
For women admitted for imminent premature delivery at 34 to 36 weeks of gestation, one or two doses of betamethasone or dexamethasone (8 to 12 mg) decrease the likelihood of neonatal respiratory distress syndrome and shorten lengths of stay in the intensive care unit.


Feb 1, 2017 Issue
Active Surveillance for Localized Prostate Cancer: No Increased Mortality, but Higher Rates of Clinical Progression
This landmark study compared active surveillance with radical prostatectomy or radiation therapy for patients with T1c or T2 prostate cancer. The benefits of active surveillance include avoiding radical therapy in one-half of the patients, with no effect on disease-specific survival or all-cause survival. The potential harms include a greater risk of metastatic disease (three additional cases per 1,000 person-years, corresponding to three additional cases for 100 men followed up for 10 years) and a greater likelihood of clinical progression.


Feb 1, 2017 Issue
Brief Interventions for Weight Management in Kids Are Not Effective
Calculating the BMI of children and adolescents in primary care practices and counseling those who are overweight is ineffective to reduce BMI in children over several years of follow-up.


Feb 1, 2017 Issue
Sertraline Reduces Risk of Depression in Adults After Traumatic Brain Injury
This study found that sertraline is more effective than placebo (number needed to treat = 6) in preventing the onset of a major depressive disorder in adults following a TBI. This study included patients with mild, moderate, and severe TBI.


Jan 15, 2017 Issue
In Patients with Vascular Disease, Treating Sleep Apnea Does Not Reduce the Risk of Cardiovascular Events
Compared with usual care, the use of CPAP provides a modest improvement in daytime sleepiness, but does not reduce the likelihood of cardiovascular events, even in a high-risk population.


Jan 15, 2017 Issue
CA 125 Relatively Specific for Diagnosing Endometriosis
For women with symptoms suggestive of endometriosis, serum CA 125 is a relatively specific (93%) and noninvasive test. It can be used to make a presumptive diagnosis in cases for which a medical management approach is being considered without having to perform a (diagnostic standard) laparoscopic procedure to confirm.


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