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Lumbar Fusion No Better Than Exercise and Therapy in the Long Term - POEMs - American ...

Dec 1, 2016 - This trial is a good example of how to do just about everything wrong to get the results you want. The authors did not conceal allocation, did not mask anyone in the study, used an unvalidated and subjective primary outcome, and downplayed the intention-to-treat analysis. Funding for ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/1201/p937.html

Venous Samples Are a Less-Painful Starting Point for the Evaluation of Patients with ...

Nov 1, 2016 - There is very good agreement between arterial and venous measurements of pH and bicarbonate, and fairly good agreement at higher levels between arterial and peripheral measures of oxygen saturation. These authors suggest an algorithm for patients with acute exacerbation of COPD that ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/1101/p757.html

Opioid Analgesia Hard to Tolerate and Not Effective for Chronic Low Back Pain - POEMs -...

Nov 1, 2016 - Effective pain control in patients with low back pain is still elusive. Approximately one-half of all patients with low back pain who take an opioid analgesic will stop treatment because of ineffectiveness or adverse effects. Patients staying the course will experience, on average, a ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/1101/p753.html

Knee Surgery Does Not Reduce Knee Catching or Locking in Patients with Meniscal Tear - ...

Aug 15, 2016 - Removing the torn bits of meniscus in middle-aged patients who have intermittent knee catches or locking does not decrease their likelihood of experiencing symptoms in the following year compared with diagnostic arthroscopy (i.e., looking but not touching). In general, meniscectomy does...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0815/p317a.html

All Analgesics Are Better Than Placebo in Patients with Knee or Hip DJD - POEMs - ...

Oct 15, 2016 - In patients with hip or knee DJD, all analgesics are more effective than placebo in relieving pain and improving function. Although paracetamol (acetaminophen) is the least effective of all the drugs studied, it still may be the first treatment for these patients because of its safety ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/1015/p664.html

Procalcitonin Guidance Safely Decreases Antibiotic Use in Critically Ill Patients - ...

Oct 15, 2016 - For patients in the intensive care unit (ICU) who receive antibiotics for presumed or proven bacterial infections, the use of procalcitonin levels to determine when to stop antibiotic therapy results in decreased duration and consumption of antibiotics without increasing mortality.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/1015/p663a.html

CBT Effective in Adolescents with Depression Who Do Not Want Medication - POEMs - ...

Sep 1, 2016 - In adolescents who eschew drug treatment of major depression, short-term CBT is more effective than treatment as usual in inducing recovery, with a number needed to treat of 4 to 10. CBT also produced faster results.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0901/p384.html

Inhaled Fluticasone-Salmeterol Better Than Fluticasone Alone for Moderate to Severe ...

Sep 1, 2016 - The combination of fluticasone and salmeterol (Advair), with the steroid dose adjusted for disease severity, reduces the number of severe asthma exacerbations more than fluticasone (Flovent) alone (number needed to treat [NNT] = 50 over 26 weeks), with no difference in terms of ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0901/p387.html

Newer Sulfonylureas Not Associated with Increased Mortality, MIs, or Strokes - POEMs - ...

Sep 1, 2016 - In multiple randomized trials, the long-term use of second- or third-generation sulfonylureas in patients with type 2 diabetes is not associated with more deaths, myocardial infarctions (MIs), or strokes. The included trials tended not to report other safety data.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0901/p386.html

Single-Dose Dexamethasone Equals Three Days of Steroids in Children with Acute Asthma -...

Aug 15, 2016 - In addition to usual beta-agonist treatment, a single dose of oral dexamethasone is as effective as three days of prednisolone (with less vomiting) in decreasing respiratory symptoms without increasing hospitalizations, follow-up visits, and days lost from school. Additional treatment ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0815/p317.html

Flibanserin Ineffective for Hypoactive Sexual Desire Disorder in Women - POEMs - ...

Sep 1, 2016 - Flibanserin produces a minimal effect on sexual desire and minimally increases the number of satisfying sexual events in women (less than one-half an event per month increase). Many women will be unable to tolerate the adverse effects.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0901/p384a.html

Pioglitazone After Stroke or TIA Reduces Stroke and MI, but Also Has Significant Harms ...

Aug 15, 2016 - In patients with a recent stroke or TIA and evidence of insulin resistance, pioglitazone reduces the likelihood of myocardial infarction (MI) or stroke (number needed to treat [NNT] = 36 over five years) but increases the risk of significant weight gain (number needed to treat to harm ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0815/p319.html

Stop Using Antipsychotics to Treat or Prevent Delirium—They Are No Better Than Placebo ...

Aug 15, 2016 - The available data indicate that antipsychotic medications are ineffective in preventing or treating delirium in hospitalized patients. Because there are concerns about falls and extrapyramidal effects with antipsychotics (not reported in this study), we should stop using them.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0815/p318.html

Genetic Test Results That Identify Increased Risk Do Not Change Behavior - POEMs - ...

Jul 15, 2016 - Patients informed via genetic test results that they were at increased risk of disease did not subsequently alter their behaviors. For example, persons at increased risk of diabetes mellitus or hypertension were no more likely to change their diet or increase their physical activity. ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0715/p168.html

No Reduction in Readmissions with Telemonitoring, Coaching for Patients with Heart ...

Jul 15, 2016 - A care transition intervention that incorporates remote monitoring of weight, blood pressure, and heart rate with scheduled telephone coaching did not reduce readmission rates at 30 days or 180 days for patients with heart failure. However, patients in the study were only modestly ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0715/p168a.html

Mediterranean Diet Produces Moderate Weight Loss - POEMs - American Family Physician

Jul 1, 2016 - In addition to improving cardiovascular outlook, a Mediterranean diet produced greater sustained weight loss than a low-fat diet and similar weight loss to other diets in patients who were overweight or obese, most of whom had type 2 diabetes mellitus.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0701/p59.html

Blood Pressure Goal of 140 to 150 mm Hg Is Best for Patients with Diabetes - POEMs - ...

Jul 1, 2016 - Although most recent practice guidelines have relaxed the blood pressure goals for patients with diabetes, there are still a few holdouts that suggest aggressive treatment. This analysis shows that the ideal range for hypertension control in patients with diabetes is between 140 and 150...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0701/p59a.html

Chondroitin/Glucosamine Equal to Celecoxib for Knee Osteoarthritis - POEMs - American ...

Jun 15, 2016 - or patients with painful knee osteoarthritis, a high-dose combination of glucosamine hydrochloride (1,500 mg) and chondroitin (1,200 mg) was as effective in lessening pain and stiffness and improving function as celecoxib (200 mg). Other studies have not found benefit.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0615/p1032.html

Behavioral Interventions Reduce Inappropriate Antibiotic Prescribing for Acute ...

Jun 15, 2016 - Requiring clinicians to justify antibiotic prescribing in the permanent electronic health record and to undergo periodic peer comparisons of prescribing rates are effective interventions for reducing inappropriate antibiotic prescribing for acute respiratory tract infections. Helpful ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0615/p1037.html

Colorectal Cancer Screening Modalities: Variable Uptake, Variable Yield - POEMs - ...

Jun 15, 2016 - Based on the initial round of screening in this randomized trial, it appears that more patients complete fecal immunochemical testing than colonography or colonoscopy. Using the most conservative estimate, the yields of advanced adenomas and advanced neoplasms are similar.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0615/p1032a.html

Meta-Analysis: Intensive BP Control Decreases Major CV Events and Stroke, but Not MI, ...

Jun 15, 2016 - Patients with hypertension who are treated intensively are less likely to have major cardiovascular events, stroke, or progression of albuminuria or retinopathy than those treated less intensively, but intensive lowering had no meaningful effect on myocardial infarctions, heart failure,...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0615/p1036.html

Naproxen Alone May Be Best for Acute Low Back Pain - POEMs - American Family Physician

Feb 15, 2016 - Naproxen alone is as effective as naproxen plus oxycodone/acetaminophen or naproxen plus cyclobenzaprine (Flexeril) in reducing pain and improving function in adults with acute musculoskeletal LBP without radicular symptoms. Adverse events were significantly more common in patients ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0215/p316.html

Long-Acting Nitrates No Good for Heart Failure with Preserved Ejection Fraction - POEMs...

May 1, 2016 - Patients who have heart failure with preserved ejection fraction had decreased levels of activity and more adverse events when they were receiving isosorbide mononitrate than when they were taking a placebo. Moreover, activity levels decreased with increases in the dose of the drug, ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0501/p790.html

Best Approaches to Physical Diagnosis of Acute Red Eye - POEMs - American Family Physician

Apr 1, 2016 - Eliciting photophobia via pupillary constriction and the presence of anisocoria (greater than 1 mm) in patients with an acute red eye are the best predictors of serious eye disease (e.g., uveitis, keratitis, corneal abrasion, scleritis) requiring prompt referral. Lack of morning eye ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0401/p594.html

Tamsulosin Effective as Expulsion Therapy for 5- to 10-mm Distal Ureteric Stones - ...

May 1, 2016 - Tamsulosin promotes stone passage of ureteric stones that are 5 to 10 mm. Five patients would need to be treated with tamsulosin to cause the expulsion of one such stone. Stones smaller than 5 mm have a high rate of spontaneous passage without any intervention.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0501/p788a.html

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