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.

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.


Jan 15, 2017 Issue
Chocolate Consumption May Make Acne Vulgaris Worse
This study found a statistically significant increase in facial acne lesions among college students 48 hours after ingesting chocolate instead of jelly beans (average compared with baseline: 4.8 new lesions vs. 0.7 fewer lesions, respectively).


Jan 15, 2017 Issue
Tamsulosin Beneficial for Passage of 5- to 10-mm Distal Ureteral Stones
Tamsulosin promotes stone passage of distal ureteral stones that are 5 to 10 mm in size. You would need to treat five such patients to get one stone passage. Smaller stones tend to pass on their own at a rate of 86% in this study.


Dec 1, 2016 Issue
Lumbar Fusion No Better Than Exercise and Therapy in the Long Term
This trial is a good example of how to do just about everything wrong to get the results you want. The authors did not conceal allocation, did not mask anyone in the study, used an unvalidated and subjective primary outcome, and downplayed the intention-to-treat analysis. Funding for the original study came from industry, and the authors have numerous conflicts of interest.


Dec 1, 2016 Issue
Step-by-Step Approach to Ruling Out Infant Infection Is Accurate
The Step-by-Step approach, using a basic physical examination and readily available urine and blood tests (without lumbar puncture; see the Synopsis section), can successfully identify low-risk infants younger than 90 days who will not need empiric antibiotic treatment and lumbar puncture.


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