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, 2017 Issue
Transdermal Estrogen and Progestogen Most Effective to Reduce Menopausal Vasomotor Symptoms
Transdermal estrogen plus progestogen, or oral estrogen plus progestogen, is the treatment most likely to effectively reduce the frequency of vasomotor symptoms among menopausal women. Isoflavones and black cohosh were found to be better than placebo.


Nov 15, 2017 Issue
YEARS Clinical Decision Tool Decreases CTA in Patients with Suspected Pulmonary Embolism
In this study, using a simplified algorithm in patients with suspected pulmonary embolism can safely decrease the number of CTAs.


Nov 15, 2017 Issue
Mite-Impermeable Covers Decrease Hospital Visits in Kids with Asthma
In children with house dust mite allergies and asthma, the use of mite-impermeable bedding decreases the frequency of asthma exacerbations.


Nov 15, 2017 Issue
Treating Sleep Apnea with Positive Airway Pressure Does Not Reduce Adverse CV Outcomes or Mortality
The use of PAP for adults with sleep apnea does not reduce adverse CV events or mortality. Patients who experience daytime fatigue at baseline benefit from reduced sleepiness and improved physical and mental well-being. Order sleep testing only in patients with signs or symptoms of sleep apnea who also experience clinically significant symptoms of daytime fatigue. No one else will benefit.


Nov 15, 2017 Issue
Use of Mindfulness or Self-Hypnosis Provides Immediate Pain Relief to Hospitalized Patients
Compared with psychoeducation, a single 15-minute session of training in mindfulness or self-hypnosis leads to greater immediate pain relief for hospitalized patients with at least moderate pain at baseline.


Oct 15, 2017 Issue
Tranexamic Acid Decreased Death from Bleeding but Not All-Cause Mortality in Women with Postpartum Hemorrhage
In this really large study, tranexamic acid did not decrease the frequency of the primary outcome of death or hysterectomy in women with postpartum hemorrhage. However, there was a very small reduction in the rate of death from bleeding in the women treated with tranexamic acid.


Oct 15, 2017 Issue
Treatment of Subclinical Hypothyroidism Ineffective in Older Adults
Treatment of patients with a minimally elevated thyrotropin (thyroid-stimulating hormone) level did not result in any improvement in symptoms. If patients present with a thyrotropin level between 4.6 and 10 mIU per L, repeat the test because the levels often normalize (this occurred in 60% of the patients initially referred for the study).


Oct 15, 2017 Issue
Newer Oral Hypoglycemics Do Not Increase or Decrease Mortality
This seems like a strange question considering that the goal is to decrease mortality with drug therapy. Nevertheless, this study showed that the new kids on the diabetes block—exenatide (Byetta), dulaglutide (Trulicity), sitagliptin (Januvia), saxagliptin (Onglyza), and others—do not increase mortality, even in patients with cardiovascular risk.


Oct 1, 2017 Issue
In Very High-Risk Patients with Vascular Disease, Evolocumab Slightly Reduces Nonfatal MI But Not Mortality
In an extremely high-risk group of patients with known vascular disease, taking evolocumab instead of placebo in addition to standard statin therapy for slightly more than two years will prevent one myocardial infarction (MI) for every 83 persons treated and prevent one stroke for every 250 persons treated.


Sep 15, 2017 Issue
No Benefit with Addition of TMP/SMX to Cephalexin for Nonpurulent Cellulitis
Compared with cephalexin alone, covering for methicillin-resistant Staphylococcus aureus (MRSA) and streptococci with cephalexin plus TMP/SMX does not improve rates of clinical cure when treating nonpurulent cellulitis. However, a trend favoring the combination regimen was found in a modified intention-to-treat population in this study, so further research may be required.


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