AFP Journal Club

Three presenters review an interesting journal article on topics that affect family physicians and give their opinions about the clinical value of the studies.

Apr 1, 2008 Issue
Treatment of Acute Ischemic Stroke with t-PA
Does the widespread use of the thrombolytic tissue plasminogen activator (t-PA) more beneficial or harmful in patients with acute stroke? The benefits must be balanced against the harms. Informed consent is necessary when making the decision.

Mar 1, 2008 Issue
Fluticasone or Salmeterol Alone vs. Combination Therapy for COPD
Is fluticasone plus salmeterol better than fluticasone or salmeterol alone for treating patients with COPD? Anticholinergics are the bronchodilators of choice. Neither fluticasone nor the combination of fluticasone and salmeterol were no better than placebo at preventing mortality.

Feb 1, 2008 Issue
Long-term PPI Therapy and the Risk of Hip Fracture
Does the long-term use of PPIs increase the risk of hip fracture? The physician must balance the risks and benefits of PPIs, especially in certain patients.

Jan 1, 2008 Issue
Choosing First-Line Therapy for Management of Type 2 Diabetes
Which controls type 2 diabetes best at five years: rosiglitazone, metformin, or glyburide? Metformin should be the first-line drug for managing type 2 diabetes. Insulin and sulfonylureas should be second line, and glitazones should be reserved for third line.

Dec 1, 2007 Issue
NSAIDs vs. Acetaminophen for the Treatment of Ankle Sprains
Are NSAIDs better than acetaminophen for ankle sprains? Extended-release acetaminophen provides equivalent analgesia and return to activity as an NSAID in patients with mild to moderate ankle sprains. All NSAIDs have equivalent analgesic effect.

Nov 1, 2007 Issue
Choosing One PPI Treatment Over Another
Is one PPI better than another? All PPIs are equally effective in equipotent dosages, and choice should be based on price.

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