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Jun 15, 2019 Issue
H. pylori Screening Before Initiation of Long-term NSAIDs [FPIN's Clinical Inquiries]
Physicians should perform laboratory screening for and eradicate H. pylori before initiating long-term NSAID therapy in NSAID-naive patients to reduce the risk of peptic ulcer disease.
In this study, after five years of treatment, patients at a moderate risk of heart disease who took low-dose aspirin did not show a decrease in coronary events and all-cause mortality and had slightly more gastrointestinal bleeding.
In this retrospective study, statin treatment in patients 75 years or older without preexisting CVD did not change the likelihood of developing CVD or reduce any-cause mortality. However, patients 75 to 84 years of age with diabetes mellitus benefitted from treatment. These results support the results from the ALLHAT study.
Feb 15, 2019 Issue
Metformin for Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis [FPIN's Clinical Inquiries]
Metformin does not seem to be an effective treatment for nonalcoholic steatohepatitis. There are no studies evaluating whether metformin improves long-term patient-oriented outcomes such as progression from NAFLD to nonalcoholic steatohepatitis, cirrhosis, hepatocellular carcinoma, or death from liver failure.
Combination oral contraceptive pills (OCPs) are an excellent treatment option for women desiring medical therapy for hirsutism. Based on this meta-analysis, an accompanying practice guideline recommends adding an antiandrogen, such as finasteride (Propecia), if there is an inadequate response within six months.
Jan 1, 2019 Issue
Deprescribing Benzodiazepine Receptor Agonists for Insomnia in Adults [Practice Guidelines]
A multidisciplinary group of clinicians as part of the Deprescribing Guidelines in the Elderly project has developed evidence-based guidelines focused on deprescribing long-term Benzodiazepine receptor agonists (BZRAs) in patients taking them for insomnia, with the goal of helping physicians and patients make appropriate decisions about BZRA use.
Oct 1, 2018 Issue
Hormone Therapy for Primary Prevention of Cardiovascular Disease in Postmenopausal Women [Medicine by the Numbers]
No benefit was observed in postmenopausal women receiving hormone therapy for primary prevention of cardiovascular disease. Find out more.
Long-term hormone therapy decreased the risk of all fractures, including hip and vertebral fractures. However, the risks far outweighed the benefits of this intervention.
Jul 1, 2018 Issue
Procalcitonin to Guide Antibiotic Therapy in Acute Respiratory Infections [Cochrane for Clinicians]
Procalcitonin-guided antibiotic therapy, when compared with routine treatments, results in decreased mortality in patients with acute respiratory infections (absolute risk reduction [ARR] = 1.4%; number needed to treat [NNT] = 71).
Just about every time someone asks, “Can I get away with a shorter course of antibiotics,” the answer is, “Yes, you can.” Shorter courses reduce cost and may reduce the likelihood of adverse events.