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Ultrasound Is Reasonably Accurate in Detecting Synovitis in Patients with Rheumatoid ...

Jun 1, 2018 - In this systematic review of patients with rheumatoid arthritis, ultrasonography was reasonably accurate compared with magnetic resonance imaging (MRI) in detecting synovitis in fingers and wrists. The use of MRI as a reference standard is convenient, but problematic.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0601/p755.html

Single Question Is Useful for Identifying Acute Mountain Sickness in Travelers at High ...

May 1, 2018 - Three different diagnostic scoring tools have similar accuracy for identifying adults at risk of AMS. One tool, the clinical functional score, is the simplest to use and consists of asking a single question.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0501/p607.html

Lumbar Fusion of Variable Value Based on Treating Diagnosis, with Significant ...

May 1, 2018 - Lumbar fusion for degenerative spinal disease appears to be most beneficial for patients undergoing the procedure for spondylolisthesis, but it is of little clear benefit for patients with other indications, such as spinal stenosis or chronic back pain.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0501/p605a.html

Broad-Spectrum Antibiotics Increase Adverse Events in Children with Acute Respiratory ...

Apr 1, 2018 - Broad-spectrum antibiotics are no more effective than narrow-spectrum antibiotics for treating acute respiratory tract infections in infants and children, and adverse events are significantly more common in children treated with broad-spectrum antibiotics.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0401/p474a.html

Exercise Alone and Various Combinations of Interventions Reduce the Risk of Injurious ...

May 1, 2018 - Exercise alone; exercise combined with vision assessment and treatment; exercise combined with vision assessment and treatment, and environmental assessment and modification; and clinic-level quality improvement strategies combined with multifactorial assessment and treatment, calcium ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0501/p606.html

Ibuprofen and Morphine Provide Similar Post-op Pain Relief in Kids; Ibuprofen Has Fewer...

Mar 15, 2018 - 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.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0315/p408a.html

High-Sensitivity Troponin I of Less Than 5 ng per L Has Negative Predictive Value of ...

Mar 15, 2018 - 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.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0315/p410.html

Routine Oxygen Supplementation After Acute Stroke Does Not Improve Functional Outcomes ...

Apr 15, 2018 - For nonhypoxic patients with acute stroke, routine oxygen therapy for 72 hours, either continuously or at night only, does not improve functional outcomes at 90 days. Long-term outcomes were not assessed in this study, and the question remains whether 90 days is an adequate length of ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0415/p533.html

Clinical Diagnosis of Lyme Disease Frequently Misses the "Bull’s Eye" - POEMs - ...

Apr 1, 2018 - For children with suspected Lyme disease but without a classic bull's-eye lesion (erythema migrans of at least 5 cm), check serology rather than rely on your clinical impression. In this study, 12% of the children not suspected of having Lyme disease did have Lyme disease, and 31% of ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0401/p474.html

Early PT for Acute Low Back Pain Is Cost-Effective, but Gain in Quality of Life Is ...

Apr 1, 2018 - At $30,000 per quality-adjusted life year (QALY) gained, early PT for acute low back pain in primary care is cost-effective by the usual criteria of $50,000 to $100,000 per QALY. However, the magnitude of improvement in quality of life is small and is probably not clinically meaningful.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0401/p475.html

Minimal Effect of ERT on Sexual Function in Menopausal Women - POEMs - American Family ...

Mar 15, 2018 - 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.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0315/p408.html

No Added Benefit with Higher Doses of Ketorolac for Treatment of Acute Pain in the ...

Aug 15, 2017 - A 10-mg dose of ketorolac is as effective as higher doses for the short-term treatment of acute pain for patients in the emergency department.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0815/p262.html

Light Therapy Improves Behavioral Disturbances, Sleep, Depression in Older Patients ...

Feb 15, 2018 - 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. ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0215/od2.html

No Effect on Mortality with Oxygen Therapy in Nonhypoxemic Patients with Suspected MI -...

Feb 15, 2018 - 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,...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0215/od3.html

Home Glucose Monitoring Offers No Benefit to Patients Not Using Insulin - POEMs - ...

Dec 15, 2017 - Home glucose monitoring of patients in primary care does not improve A1C scores or quality of life over one year in patients who are not taking insulin.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1215/od4.html

Long-Term Use of Bisphosphonates Increases the Risk of Fractures in Older Women - POEMs...

Jan 1, 2018 - In this cohort study, older women at a high risk of fractures who used oral bisphosphonates for 10 to 13 years had a higher risk of fractures than women who used bisphosphonates for only two years.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0101/p53a.html

Oral Steroids Not Helpful for Acute Lower Respiratory Tract Infection in Nonasthmatic ...

Jan 1, 2018 - This study found no clinically significant benefit of steroids for the treatment of acute LRTI in adults without asthma, including those presenting with wheezing or shortness of breath.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0101/p55.html

Delayed Antibiotic Prescription for New-Onset Cough Associated with Decreased ...

Jan 1, 2018 - 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.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0101/p53.html

Intensive Blood Pressure Control in Older Patients Can Decrease Renal Function - POEMs ...

Jan 1, 2018 - 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...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0101/p54.html

Gabapentinoids for Chronic Low Back Pain: Limited Evidence, More Harm Than Benefit - ...

Dec 15, 2017 - The existing data on gabapentinoids for chronic low back pain are limited in number and quality. The amount of pain reduction is low to moderate, and the rate of adverse effects is high. The few studies that assessed function found no improvement.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1215/od3.html

In Hospitalized Patients with Influenza and an Infiltrate, Adding Clarithromycin and ...

Dec 15, 2017 - Adding clarithromycin and naproxen to oseltamivir significantly lowered all-cause mortality at 30 days and at 90 days. This study was limited by its open-label design. The outcome of mortality would not be subject to observer bias, though, and the groups were balanced.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1215/od5.html

Transdermal Estrogen and Progestogen Most Effective to Reduce Menopausal Vasomotor ...

Dec 1, 2017 - 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.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1201/p744.html

Use of Mindfulness or Self-Hypnosis Provides Immediate Pain Relief to Hospitalized ...

Nov 15, 2017 - 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.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1115/od6.html

Mite-Impermeable Covers Decrease Hospital Visits in Kids with Asthma - POEMs - American...

Nov 15, 2017 - In children with house dust mite allergies and asthma, the use of mite-impermeable bedding decreases the frequency of asthma exacerbations.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1115/od4.html

Treating Sleep Apnea with Positive Airway Pressure Does Not Reduce Adverse CV Outcomes ...

Nov 15, 2017 - 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 ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1115/od5.html

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