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.

Dec 1, 2018 Issue
Mifepristone Pretreatment Improves Success Rate of Misoprostol for Early Pregnancy Loss
In women with early pregnancy loss between five and 12 weeks' gestation, pretreatment with 200 mcg of oral mifepristone before 800 mcg of vaginal misoprostol increases the likelihood of successful expulsion of the gestational sac.


Dec 1, 2018 Issue
Incidental Findings Are Common with Chest CT and MRI of the Spine and Brain
The risks of imaging, in addition to radiation exposure, include the identification of incidentalomas, which can lead to patient anxiety, further testing, and overtreatment. There is little research to guide what to do when they pop up on an imaging report (as the famous dodge “clinical correlation needed”).


Dec 1, 2018 Issue
Direct Oral Anticoagulants Preferred Over Warfarin for Nonvalvular Atrial Fibrillation in Patients Also Taking Low-Dose Aspirin
The balance of benefits and harms favors direct oral anticoagulants over warfarin (Coumadin) for patients with nonvalvular atrial fibrillation who require anticoagulation and are already taking low-dose aspirin.


Dec 1, 2018 Issue
Advance Care Planning Increases Execution of Advance Directives and Surrogate Decision-Maker Assignment
In this study, an intensive advance care planning intervention dramatically increased the completion of advance directives and the identification of surrogate decision makers.


Nov 15, 2018 Issue
Acupuncture Effective for Chronic Pain Conditions
Acupuncture, with its meridians, chi, and other concepts that do not seem to line up with anything physiologic, is vexing to most of us who trained in Western medicine. However, this meta-analysis, based on data from almost 21,000 patients, found it to be more effective than no treatment and, to a lesser extent, more effective than sham acupuncture.


Nov 15, 2018 Issue
Breast Cancer Screening with MRI: More False-Positives, More Biopsies
Screening with MRI is not for everyone. Women who undergo breast cancer screening with MRI are much more likely to be referred for biopsy— that will ultimately be negative—than if they have screening mammography alone.


Nov 15, 2018 Issue
Estrogen No Better Than Vaginal Lubricant for Postmenopausal Vaginal Symptoms
It is time to rethink the idea that vaginal atrophy caused by diminished estrogen is the cause of vaginal symptoms associated with menopause. Vaginal estradiol is no more effective than a non-prescription vaginal lubricant or placebo lubricant in the treatment of women with painful intercourse, vaginal dryness, or other symptoms usually associated with menopause.


Nov 15, 2018 Issue
As-Needed Use of Budesonide Plus Formoterol As Good As Daily Use of Steroid
As-needed use of budesonide/formoterol is as effective as the daily use of maintenance budesonide plus as-needed terbutaline at preventing severe exacerbations, and results in a much lower cumulative steroid dose.


Oct 15, 2018 Issue
Long-Acting Muscarinic Antagonists plus Inhaled Steroids is Equal to Long-Acting Beta-Agonists Plus Inhaled Steroids
Long-acting muscarinic antagonists added to inhaled corticosteroids are a superior treatment to placebo for improving asthma control in adults and children 12 years or older. Long-acting muscarinic antagonist add-on therapy is not superior to long-acting beta agonist (LABA) add-on therapy.


Oct 15, 2018 Issue
Five-Day Nitrofurantoin Superior to Single-Dose Fosfomycin for Women with Uncomplicated UTI
A five-day course of nitrofurantoin is significantly more likely than single-dose fosfomycin to achieve both clinical and microbiologic resolution of uncomplicated lower UTI in otherwise healthy adult women.


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