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, 2018 Issue
Minimal Effect of ERT on Sexual Function in Menopausal Women
Transdermal, but not oral, estrogen produced a small improvement in sexual function scores in menopausal women. The increases were very small and may not be noticeable by most women.

Mar 15, 2018 Issue
Ibuprofen and Morphine Provide Similar Post-op Pain Relief in Kids; Ibuprofen Has Fewer Harms
This carefully designed and adequately powered study found no difference in pain reduction between ibuprofen and oral morphine in children with postoperative pain. Adverse effects, however, were much more likely with morphine.

Mar 15, 2018 Issue
High-Sensitivity Troponin I of Less Than 5 ng per L Has Negative Predictive Value of 99.9% for Cardiac Death at One Year
A cardiac troponin I concentration of less than 5 ng per L in adults who present with potential acute coronary syndrome has a negative predictive value (NPV) of at least 99.9% for cardiac death at 30 days and at one year.

Mar 1, 2018 Issue
Ibuprofen Plus Acetaminophen Equals Opioid Plus Acetaminophen for Acute Severe Extremity Pain
In adults presenting to the emergency department with acute extremity pain severe enough to warrant radiologic investigation, ibuprofen plus acetaminophen was equally effective in reducing pain intensity at two hours compared with three different opioid and acetaminophen combination analgesics.

Feb 15, 2018 Issue
Lorazepam Added to Haloperidol Effective for Agitated Delirium in End-of-Life Cancer Patients
Using a single dose of lorazepam in combination with haloperidol decreases agitation in end-of-life patients with cancer who had persistent agitated delirium despite scheduled haloperidol. A recent POEM reported that haloperidol increases symptoms of distress in patients with cancer and acute delirium who are receiving palliative care.

Feb 15, 2018 Issue
No Effect on Mortality with Oxygen Therapy in Nonhypoxemic Patients with Suspected MI
In patients with suspected MI and normal oxygen levels, giving immediate supplemental oxygen therapy does not improve mortality at one year. Although this study was underpowered because of fewer than expected deaths in the control group, the results were consistent across all subgroups, as well as with findings from other literature.

Feb 15, 2018 Issue
Light Therapy Improves Behavioral Disturbances, Sleep, Depression in Older Patients with Cognitive Impairment
In this meta-analysis, older patients with cognitive impairment who were exposed to light therapy had moderate improvements in behavioral disturbances, small improvements in sleep quality, and moderate improvements in depression. The authors did not report data on responders vs. nonresponders or on the potential adverse effects of treatment.

Feb 15, 2018 Issue
Single-Dose Oral Dexamethasone Decreases Sore Throat Pain
Sore throats are rarely fatal anymore, but there is really no such thing as “just a sore throat.” Whereas antibiotics have no analgesic activity, a single low dose of a corticosteroid such as oral dexamethasone—0.6 mg per kg for children at least five years of age and up to 10 mg for adults—is effective in decreasing pain in the first 24 hours.

Jan 1, 2018 Issue
Delayed Antibiotic Prescription for New-Onset Cough Associated with Decreased Reconsultation
Delayed antibiotic treatment (that is, giving a prescription with a suggestion to fill it only if symptoms are still present after three days) was associated with decreased revisits by adults with new-onset cough deemed to be infective.

Jan 1, 2018 Issue
Intensive Blood Pressure Control in Older Patients Can Decrease Renal Function
In this post-hoc analysis of the previously published SPRINT trial, lowering the systolic blood pressure of patients who are at increased risk of cardiovascular events (average age = 66 years) will decrease their risk of cardiovascular disease but increase their likelihood of developing moderate renal dysfunction.

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