Essential evidence: medicine that matters ; InfoPOEMs
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| Format: | Book |
|---|---|
| Language: | English |
| Published: |
Hoboken, NJ
Wiley-Interscience
2007
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| Subjects: | |
| Online Access: | Inhaltsverzeichnis |
| Item Description: | InfoPOEMs, daily doses of knowledge |
| Physical Description: | XXX, 510 S. |
| ISBN: | 0470178906 9780470178904 |
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MARC
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| 245 | 1 | 0 | |a Essential evidence |b medicine that matters ; InfoPOEMs |c David Slawson ... |
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| 500 | |a InfoPOEMs, daily doses of knowledge | ||
| 650 | 4 | |a Evidence-Based Medicine |v Abstracts | |
| 650 | 4 | |a Evidence-based medicine | |
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| adam_text | Contents
Preface xxi
Taking an Evidence-Based Approach to the Care of Patients xxii
How to Become an Information Master: Feeling Good about NOT
Knowing Everything xxvii
InfoPOEMs (Patient-Oriented Evidence that Matters) 1
Cancer 3
Breast cancer 3
Most women with breast cancer have no risk factors 3
Raloxifene reduces breast cancer risk (CORE) 4
Raloxifene and tamoxifen equally effective in reducing breast cancer risk 5
Raloxifene decreases breast cancer risk, no effect on cardiovascular disease
risk (RUTH) 6
MRI more accurate than mammogram in high-risk patients 7
MRI more sensitive than mammography in high-risk women (MARIBS) 8
Digital mammography more sensitive for younger women 9
Mammography results in overdiagnosis 10
Annual mammography starting at 40 doesn t lower breast cancer mortality 11
Gynecologic cancers 12
Many unnecessary Pap smears are performed after hysterectomy 12
Specific HPV strains are associated with cervical cancer risk 13
Vaccine effective against HPV 14
Bivalent vaccine against HPV effective for 4.5 years 15
Liquid-based not better than conventional Pap 16
Endometrial sampling adequate for diagnosing endometrial cancer 17
Melanoma 18
Melanoma incidence really not rising 18
Lifetime risk of mole transforming to melanoma very low 19
0.7% of congenital melanocytic nevi become malignant 20
Dermoscopy with validated criteria more sensitive than unaided eye 21
Larger margins better in melanoma 2mm thick 22
Prevention and screening 23
Antioxidants don t prevent Cl cancers, and may increase overall mortality 23
Vitamin E doesn t lower women s risk of cardiovascular disease or cancer 24
Antioxidants don t prevent colorectal cancer 25
Mammography, FOBT and CXR don t reduce all-cause mortality 26
Spiral CT detects early lung cancer, but screening use is premature 27
Cancer linked to some diabetes treatments 28
Prostate cancer 29
Finasteride of mixed benefit in preventing prostate cancer 29
Prostate cancer screening every 4 years as good as annually 30
False-positive PSA associated with increased worry, fears 31
Elevated PSA should be confirmed before biopsy 32
Radical prostatectomy improves outcomes in symptom-detected prostate cancer 33
Cardiology 34
Acute myocardial infarction and acute coronary syndromes 34
Early metoprolol in acute Ml: no benefit, possible harm (COMMIT; CCS-2) 34
Insulin/dextrose infusion ineffective in AMI (HI-5) 35
Early initiation of statins following ACS does not improve outcomes 36
Antibiotics not effective in acute coronary syndromes 37
ABCDE approach to non-ST-segment elevation ACS 38
Door-to-balloon time important in STEMI 39
Routine invasive strategy may be preferred for ACS 40
Intensive medical tx + selective PCI preferred for non-ST ACS 41
Invasive tx slightly better in non-ST-elevation ACS (RITA3) 42
In ACS, 5years of invasive tx decreases Ml but not all cause mortality (FRISC-II) 43
Captopril = losartan for reducing all-cause mortality after Ml 44
Captopril better than valsartan or combination post-MI 45
Implantable defibrillators are not effective post-MI 46
Anticoagulation management 47
Start warfarin at lOmg faster for outpatient anticoagulation 47
Use an algorithm to start warfarin in older patients 48
Self-monitoring of anticoagulation safe, effective 49
Self-monitoring anticoagulation superior at preventing venous
thromboembolics events 50
INR 1.5-1.9 less effective than 2.0-3.0 for idiopathic DVT 51
Oral vitamin K works faster than subcutaneous 52
Oral vitamin K effective for warfarin overdose 53
Atrial fibrillation 54
Clinical decision rules accurately predict stroke risk in atrial fibrillation 54
Thromboembolism just as likely with atrial flutter 55
Warfarin prevents more strokes than clopidorel + ASA in atrial fibrillation (ACTIVE) 56
Ximelagatran effective in preventing stroke in atrial fibrillation 57
Quality of life with rate or rhythm control in atrial fibrillation (AFFIRM) 58
Rate control better than rhythm control in atrial fibrillation (AFFIRM) 59
Amiodarone sotalol placebo for maintaining NSR in atrial fibrillation (SAFE-T) 60
Coronary artery disease 61
Mediterranean diet associated with lower all cause mortality 61
Coffee does not increase risk of developing CAD 62
Vitamin E has no effect on cardiovascular disease 63
Lowering homocysteine does not reduce cardiovascular disease (HOPE 2) 64
Omega 3 fatty acids do not affect mortality 65
Fotic acid supplementation does not reduce cardiovascular disease risk nor mortality 66
Fenofibrate doesn t prevent coronary events in DM (FIELD) 67
Optimal oral antiplatelet therapy for vascular disease 68
Clopidogrel + ASA no better than ASA alone for high-risk patients 69
Clopidogrel beneficial added to ASA, fibrinolytic in STEMI 70
Aspirin reduces risk of CV events, increases risk of bleeding 71
Aspirin + PPI safer than clopidogrel if history of Cl bleed 72
Electron beam tomography not helpful 73
Chest pain relief by NTC doesn t predict active CAD 74
Ranolazine adds little to maximum antianginal therapy (ERICA) 75
Better outcomes with CABC than PCI with stent for 2,3 vessel disease 76
Adding ACEI doesn t improve outcomes in stable angina w/nl LVEF (PEACE) 77
COX-2 inhibitors and heart disease 78
Rofecoxib increases risk of cardiovascular events 78
Celecoxib increases risk of cardiovascular complications 79
Rofecoxib, diclofenac and indomethacin increase risk of CVD 80
Heart failure 81
BNP improves outcomes in evaluation of dyspnea 81
BNP testing beneficial with CHF + pulmonary dx 82
Serial BNP levels predict risk of death and CHF after ACS 83
Higher BNP and N-ANP predict CV events 84
ARBs = ACEIs for all-cause mortality in heart failure 85
Optimal digoxin range for men 0.5 to 0.8ng/ml 86
Digoxin increases mortality in women with heart failure 87
Nesiritide for CHF may increase mortality risk 88
Implantable defibrillators reduces mortality in NYHA Class II heart failure 89
Hypertipidemia 90
Herbs may reduce cholesterol, no data on clinical outcomes 90
Statins prevent CAD 91
Cholesterol lowering cost-effective in high-risk elderly 92
Intensive lipid lowering of marginal benefit even if high-risk 93
Varying effects of lipid drugs on overall mortality 94
Statins equivalent for CVD prevention 95
Intensive lipid lowering with statins unnecessary with stable CAD (IDEAL) 96
Hypertension 97
JNC 7 report on prevention/evaluation/treatment of hypertension 97
Work stress has no meaningful effect on blood pressure 98
Pseudoephedrine has a minimal effect on blood pressure 99
Habitual caffeine intake does not increase risk of hypertension in women 100
Home blood pressure monitoring valuable 101
Office measurements usually overestimate blood pressure 102
Hypertension follow-up: 3 months = 6 months 103
Patients with HTN + high lipids may benefit less from statins (ALLHAT) 104
Excessive lowering of blood pressure causes more harm than good 105
Diuretics clearly first line agent for HTN (ALLHAT) 106
Meta-analysis supports diuretics as first line for HTN 107
Outcomes for thiazides similar 108
ACEI better than diuretic in older men for hypertension 109
Atenolol of questionable efficacy for HTN 110
Beta-blockers placebo, not other drugs, in preventing HTN complications 111
Renal function similarly affected by antihypertensives (ALLHAT) 112
Peripheral vascular disease and aneurysm 113
Screening program for abdominal aortic aneurysm ineffective 113
Fewer aneurysm deaths but not overall deaths with AAA screening 114
CABG not helpful before AAA or peripheral vascular surgery 115
EVAR worse than open repair of AAA (EVAR Trial 1) 116
Bypass = angioplasty for severe leg ischemia, but costs more (BASIL) 117
Pulmonary hypertension 118
Sildenafil effective for primary pulmonary hypertension 118
Sildenafil = bosentan in pulmonary hypertension (SERAPH) 119
Thrombophilias 120
Testing for prothrombotic defects not necessary after first DVT 120
Management of antiphospholipid antibody syndrome 121
Venous thromboembolism 122
Fixed-dose, subcutaneous, unfractionated heparin effective for VTE 122
Compression stockings prevent post-thrombotic syndrome 123
Routine use of vena cava filters doesn t reduce mortality 124
At least 6 months of anticoagulation optimal to prevent recurrent VTE 125
LMWH better than warfarin in preventing recurrent DVT in cancer patients 126
Venous thromboembolism diagnosis and prognosis 127
Best tests to rule in, rule out PE 127
Clinical prediction rules accurate for PE diagnosis 128
Validated algorithm for evaluating suspected PE 129
Optimal algorithm for evaluating suspected DVT 130
Multidetector CT accurate for PE, but requires clinical context 131
Negative CT scan to rule out PE equal to angiography 132
Determining major bleeding risk with warfarin for DVT 133
D-dimer useful for excluding DVT and PE 134
D-dimer 250ng/mL predicts low risk of VTE recurrence 135
Care of Infants and Children 136
ADHD 136
Restricted diet improves parental perception of hyperactive behavior 136
Stimulants similarly effective for ADHD 137
Responders to atomoxetine do welt with lower doses 138
Anemia 139
Anemia not prevented by iron in infants 139
Anemia doesn t predict iron deficiency among toddlers 140
Asthma 141
Long-term budesonide does not effect adrenal function in children 141
Amoxicillin for 3 days effective for pediatric pneumonia 142
Educational programs effective for young asthmatics 143
Diarrhea 144
Nitazoxanide reduces rotavirus duration in hospitalized kids 144
Oral rotavirus vaccines safe and effective 145
Intense diet-behavior-physical activity effective for obese children 146
Evidence lacking for milk s benefit in children 147
Prevention 148
Vaccine exposure does not increase risk of infectious disease hospitalization 148
Dental restoration with amalgam (mercury) safe in children 149
School-based violence prevention programs not proved 150
Otitis media 151
Delayed prescription for AOM reduces unnecessary antibiotics 151
Parent satisfaction okay with no treatment of AOM 152
Parents prefer shared decision-making for AOM 153
Tubes marginally effective in otitis media with effusion 154
Early tympanostomy tubes do not improve outcomes after 3 or more years 155
Prompt tympanostomy tube insertion doesn t improve 9year outcomes 156
Other pediatric problems 157
Bed and pillow covers ineffective for allergic rhinitis 157
Risk scoring system predicts mortality in pediatric ICU 158
Petroleum jelly doesn t reduce recurrent pediatric epistaxis 159
Effective and ineffective interventions for infant colic 160
Respiratory infections and fever 161
Ear thermometry is unreliable in detecting fever 161
Acetaminophen, ibuprofen comparable for pain, fever in children 162
Cough suppressants ineffective in children 163
Delayed prescriptions for URIs reduce antibiotic use 164
Amoxicillin for 3 days effective for pediatric pneumonia 165
Sore throat 166
Herbal tea effective for symptoms of acute pharyngitis 166
Steroids provide brief relief of pain in mononucleosis 167
Echinacea purpurea ineffective for treating URI in kids 168
Complementary and Alternative Medicine 169
Diarrhea 169
Yogurt prevents antibiotic-associated diarrhea 169
Probiotics helpful for antibiotic-associated diarrhea 170
Probiotics effective in preventing acute diarrhea, but not traveler s diarrhea 171
Diet and exercise 172
Popular diets equally effective for losing weight 172
Mediterranean diet associated with lower all cause mortality 173
Omega 3 fatty acids do not affect mortality 174
Diet and exercise prevent diabetes in high-risk patients 175
Mental health problems 176
Restricted diet improves parental perception of hyperactive behavior 176
Variable support for CAM therapies for anxiety 177
Antioxidants do not prevent dementia 178
Lowering homocysteine with B vitamins doesn t improve
cognition 179
Vitamin E, donepezil ineffective for mild cognitive impairment 180
Light therapy as effective as fluoxetine for seasonal affective disorder 181
Musculoskeletal problems 182
Acupuncture effective for chronic back pain 182
Tai chi improves symptoms of osteoarthritis 183
Acupuncture effective for OA of the knee 184
Acupuncture ineffective for fibromyalgia 185
Acupuncture better than sham treatment for neck pain 186
Prevention of cancer 187
Vitamin E not helpful, perhaps harmful 187
Vitamin E doesn t lower women s risk of cardiovascular disease or cancer 188
Vitamin E has no effect on cardiovascular disease 189
Antioxidants don t prevent Gl cancers, and may increase overall mortality 190
Antioxidants don t prevent colorectal cancer 191
Green tea consumption is associated with reduced mortality 192
DHEA, testosterone not effective in aging patients 193
Lowering homocysteine does not reduce cardiovascular disease (HOPE 2) 194
Folic acid supplementation does not reduce cardiovascular disease risk
nor mortality 195
Herbs may reduce cholesterol, no data on clinical outcomes 196
Upper respiratory problems 197
Herbal tea effective for symptoms of acute pharyngitis 197
Petroleum jelly doesn t reduce recurrent pediatric epistaxis 198
Saline nasal irrigation effective for frequent sinusitis 199
Forcing fluids during a respiratory infection unsupported by studies 200
Zinc nasal gel reduces duration of common cold 201
Echinacea purpurea ineffective for treating URI in kids 202
Echinacea doesn t shorten or lessen cold symptoms 203
Women s health 204
Black cohosh ineffective for vasomotor symptoms 204
Acupuncture ineffective for hot flashes 205
Lactobacillus doesn t prevent post-antibiotic vaginitis 206
Immersion exercise reduces leg edema in pregnancy 207
Endocrinology 208
Diabetes 208
Diet and exercise prevent diabetes in high-risk patients 208
Treating prediabetes does not affect progression 209
Rosiglitazone delays developing diabetes mellitus (DREAM) 210
Hypertension control most important aspect of diabetes care 211
Fenofibrate doesn t prevent coronary events in diabetes mellitus (FIELD) 212
Home glucose monitoring makes little difference in type 2 diabetes 213
Rosiglitazone more likely to succeed as monotherapy clinical outcomes no better 214
ACE inhibitors beneficial in diabetics 215
ARB no better than ACEI for prevention of nephropathy progression 216
Pioglitazone ineffective in secondary prevention of macrovascular
complications (PROactive) 217
Cancer linked to some diabetes treatments 218
Duloxetine decreases pain of diabetic neuropathy 219
Obesity 220
Weight loss interventions have little effect on quality of life 220
Popular diets equally effective for losing weight 221
Intense diet-behavior-physical activity effective for obese children 222
Rimonabant minimally effective for weight loss 223
Topiramate beneficial for binge eating disorder with obesity 224
Bariatric surgery effective for morbid obesity 225
Eye, Ear, Nose and Throat 226
Allergic rhinitis 226
Bed and pillow covers ineffective for allergic rhinitis 226
Pollen blocker cream effective for allergic rhinitis 227
Montelukast alone ineffective for allergic rhinitis 228
Epistaxis 229
Petroleum jelly doesn t reduce recurrent pediatric epistaxis 229
Eye problems 230
Lutein improves vision with macular degeneration in men 230
Three indicators herald bacterial conjunctivitis in adults 231
Antibiotics for conjunctivitis decreases symptom duration 232
Diet high in beta carotene, vitamins C and E, and zinc may reduce risk of
macular degeneration 233
Otitis media 234
Parent satisfaction okay with no treatment of AOM 234
Parents prefer shared decision-making for AOM 235
Delayed prescription for AOM reduces unnecessary antibiotics 236
Tubes marginally effective in otitis media with effusion 237
Early tympanostomy tubes do not improve outcomes after 3 or more years 238
Prompt tympanostomy tube insertion doesn t improve 9year outcomes 239
Sinusitis 240
Saline nasal irrigation effective for frequent sinusitis 240
Intranasal steroids alone effective for acute uncomplicated sinusitis 241
Sore throat 242
Herbal tea effective for symptoms of acute pharyngitis 242
Steroids provide brief relief of pain in mononucleosis 243
URI 244
Gargling with water prevents colds 244
Delayed prescriptions for URIs reduce antibiotic use 245
Forcing fluids during a respiratory infection unsupported by studies 246
Zinc nasal gel reduces duration of common cold 247
Echinacea purpurea ineffective for treating URI in kids 248
Antibiotics slightly effective for purulent rhinitis 249
Echinacea doesn t shorten or lessen cold symptoms 250
Gastrointestinal Problems 251
Diarrhea and gastroenteritis 251
Yogurt prevents antibiotic-associated diarrhea 251
Probiotics helpful for antibiotic-associated diarrhea 252
Probiotics effective in preventing acute diarrhea, but not traveler s diarrhea 253
Nitazoxanide reduces rotavirus duration in hospitalized kids 254
Oral rotavirus vaccines safe and effective 255
Ondansetron effective for gastroenteritis with vomiting 256
Dyspepsia and gastrointestinal bleeding 257
Omeprazole 20mg = 40mg for primary care acid-related dyspepsia 257
Omeprazole, ranitidine effective for HP negative dyspepsia (CADET-HN) 258
4 drugs for 1 day eliminates H. pylori 259
Aspirin + PPI safer than clopidogrel if history of Cl bleed 260
Castroesophageal reflux disease 261
A PPI test does not improve diagnosis of CERD 261
Lifestyle changes of little benefit in CERD 262
All PPIs equivalent for treatment of CERD 263
Hepatobiliary disorders 264
Acetaminophen does not affect liver function in alcoholics 264
Evaluation of abnormal liver chemistries 265
Enteral nutrition preferred in pancreatitis 266
Antibiotic prophylaxis reduces mortality in hospitalized cirrhotics 267
Cynecology 268
Cervical and endometrial cancer 268
Many unnecessary Pap smears are performed after hysterectomy 268
Specific HPV strain are associated with cervical cancer risk 269
Vaccine effective against HPV 270
Bivalent vaccine against HPV effective for 4.5 years 271
Liquid-based not better than conventional Pap 272
Endometrial sampling adequate for diagnosing endometrial cancer 273
Infertility and contraception 274
Avoid nonoxynol-9 spermicides with less than 100g per dose 274
Metformin increases fertility in PCOS 275
Menopause 276
HRT with estrogen alone increases stroke, decreases fractures 276
Clonidine, gabapentin, and some SSRIs effective for hot flashes 277
Black cohosh ineffective for vasomotor symptoms 278
Acupuncture ineffective for hot flashes 279
HRT increases risk of stress, urge urinary incontinence 280
Vaginitis 281
Weekly fluconazole reduces recurrent candidiasis, though costly 281
Lactobacillus doesn t prevent post-antibiotic vaginitis 282
Hematology 283
Anemia 283
Anemia not prevented by iron in infants 283
Anemia doesn t predict iron deficiency among toddlers 284
Repeated blood testing causes anemia 285
Oral as good as IM vitamin B12 replacement 286
Thrombophilias 287
LMWH better than warfarin in preventing recurrent DVT in cancer patients 287
Testing for prothrombotic defects not necessary after first DVT 288
Management of antiphospholipid antibody syndrome 289
Infectious Disease 290
Prevention 290
Oral rotavirus vaccines safe and effective 290
Acellular pertussis vaccine 63% to 92% effective 291
Vaccine exposure does not increase risk of infectious disease hospitalization 292
Antibacterial household products don t reduce infectious symptoms 293
Prescribing practices 294
Cephalosporins often safe in PCN-allergic patients 294
Prescribing antibiotics does not save time 295
Delayed prescription for AOM reduces unnecessary antibiotics 296
Delayed prescriptions for URIs reduce antibiotic use 297
Respiratory infections 298
Flu shots are effective in elderly 298
Useful signs and symptoms for diagnosis of influenza 299
Steroids provide brief relief of pain in mononudeosis 300
Kidney Diseases 301
Diabetic nephropathy 301
ACE inhibitors beneficial in diabetics 301
ARB no better than ACEI for prevention of nephropathy progression 302
Gout 303
Meat, seafood, and little dairy are risk factors for gout 303
Febuxostat = allopurinol for gout prophylaxis 304
Renal failure 305
Low-dose dopamine ineffective for acute renal failure 305
Furosemide doesn t prevent acute renal failure 306
Urinary tract infection and dysuria 307
Treating negative dipstick dysuria decreases symptoms 307
Immediate- and extended-release ciprofloxacin similar for UTI 308
Musculoskeletal Problems 309
Back and neck pain 309
Acupuncture effective for chronic back pain 309
Surgery better than no surgery for spinal stenosis 310
Acupuncture better than sham treatment for neck pain 311
Useful treatments for fibromyalgia syndrome 312
Acupuncture ineffective for fibromyalgia 313
Degenerative joint disease 314
Acetaminophen = celecoxib in DJD 314
Knee taping useful for osteoarthritis pain 315
Tai chi improves symptoms of osteoarthritis 316
Acupuncture effective for OA of the knee 317
Rofecoxib increases risk of cardiovascular events 318
Celecoxib increases risk of cardiovascular complications 319
Rofecoxib, diclofenac and indomethacin increase risk of CVD 320
Rofecoxib cardiovascular risks known in 2000 321
Arthroscopy ineffective for osteoarthritis of knee 322
Obesity does not effect 5-year knee replacement outcomes 323
Osteoporosis and fractures 324
Monthly vitamin D prevents fractures 324
Calcium/vitamin D effective for prevention of first fracture 325
Calcium/vitamin D not effective for secondary prevention of fracture (RECORD) 326
1000mg calcium/400 IU vit D not very effective for fracture prevention (WHI) 327
HRT with estrogen alone increases stroke, decreases fractures 328
Long-term PPI use increases hip fracture risk 329
Most women quickly stop taking bisphosphonates 330
Evidence lacking for milk s benefit in children 331
Folate and vitamin B12 lowers fracture risk after stroke 332
Falls prevented in elderly by formal assessment or exercise program 333
Early mobilization better for acute limb injuries 334
Other musculoskeletal problems 335
Nonsurgical treatment effective for carpal tunnel 335
PET scan best in chronic osteomyelitis diagnosis 336
Extracorporeal shock wave therapy is ineffective for tennis elbow 337
Tennis elbow: injection better short-term, worse long-term 338
Neurology 339
Headache 339
Metoclopramide (Reglan) effective in migraine 339
Intranasal zolmitriptan effective for cluster headaches 340
Specific headache criteria useful for migraine diagnose, neuroimaging 341
Herpes zoster 342
Herpes zoster vaccine safe and effective for older adults 342
Tricyclics drug of choice for post-herpetic neuralgia 343
Insomnia 344
Melatonin effective for some sleep disorders 344
Cognitive therapy superior to zopiclone for insomnia 345
Syncope and vertigo 346
Simple maneuvers can decrease vasovagal syncope episodes 346
Steroid effective for vestibular neuritis, valacyclovir is not 347
Stroke 348
ASA prevents stroke, not Ml, in women 348
ASA + dipyridamole better than ASA for cerebral ischemia (ESPRIT) 349
Warfarin increases mortality in intracranial arterial stenosis 350
Lipid-lowering prevents stroke in patients with or without CHD 351
High-dose atorvastatin reduces recurrent stroke, not mortality
(SPARCL) 352
ABCD rule predicts 7-day stroke risk in TIA 353
ABCD rule predicts 7- and 30-day stroke risk in patients with TIA 354
Eight clinical findings distinguish stroke from stroke mimics 355
Noninvasive carotid imaging can replace invasive imaging 356
Three percent of TIA patients have a stroke within 30 days (BASIC) 357
Endarterectomy best within 2 weeks of stroke or TIA 358
Carotid stent inferior to carotid endarterectomy 359
PEG tubes worsen quality of life in stroke (FOOD) 360
Pregnancy Care 361
Labor management 361
Fetal pulse oximetry does not reduce operative delivery 361
Suction before delivery of shoulders doesn t prevent meconium aspiration 362
VBAC with prior vaginal delivery safer than cesarean 363
Prenatal care 364
Risk-based screening for CDM effective 364
Steroids effective for hyperemesis gravidarum 365
Immersion exercise reduces leg edema in pregnancy 366
Aspirin = enoxaparin for prevention of recurrent miscarriage 367
Preterm labor 368
Prenatal vaginal infection screening + treating reduces preterm delivery 368
Oral clindamycin for BV prevents prematurity 369
Psychology and Substance Abuse 370
ADHD 370
Restricted diet improves parental perception of hyperactive behavior 370
Stimulants similarly effective for ADHD 371
Responders to atomoxetine do well with lower doses 372
Antipsychotics and schizophrenia 373
Newer antipsychotics similar to older agents (CATIE) 373
Atypical antipsychotics minimally effective, poorly tolerated in
Alzheimer s disease 374
Older, newer antipsychotics both increase mortality in elderly 375
Anxiety and stress 376
Variable support for CAM therapies for anxiety 376
Work stress has no meaningful effect on blood pressure 377
Dementia 378
Antioxidants do not prevent dementia 378
Lowering homocysteine with B vitamins doesn t improve cognition 379
Reasoning training slows age-related functional decline 380
Statins not associated with decreased dementia 381
Vitamin E, donepezil ineffective for mild cognitive impairment 382
Drug therapy minimally effective for neuropsych symptoms of dementia 383
Minimal effect of cholinesterase inhibitors for Alzheimer s 384
Haloperidol shortens duration, intensity but not frequency of post-up delirium 385
Small increased risk of death with atypical antipsychotics for dementia 386
Older, newer antipsychotics both increase mortality in elderly 387
Depression 388
Two question screening for depression effective 388
No difference among new antidepressants 389
Alternative medications are similarly effective for depression treatment
failures (STAR*D) 390
Suicide rates equal regardless of antidepressant type 391
Antidepressant drugs increase suicidal behavior in children 392
Newer antidepressants increase suicidality in youths 393
Light therapy as effective as fluoxetine for seasonal affective disorder 394
Tobacco abuse 395
Smoking cessation 6-8 weeks before surgery reduces complications 395
12 weeks of varenicline is effective for smoking cessation 396
6 weeks of varenicline is also effective for smoking cessation 397
Respiratory Problems 398
Asthma 398
Educational programs effective for young asthmatics 398
Bed and pillow covers ineffective for asthma 399
Exhaled nitric oxide and sputum analysis useful for asthma diagnosis 400
Intermittent = continuous therapy for mild persistent asthma 401
Salmeterol + fluticasone better than fluticasone for asthma (COAL) 402
Don t double steroid dose in deteriorating asthma 403
Long-term budesonide does not effect adrenal function in children 404
COPD 405
Procalcitonin test can reduce antibiotic use in COPD 405
Corticosteroids benefit patients with moderate to severe COPD 406
Anticholinergics are better than beta-agonists in COPD treatment 407
Lower respiratory infections 408
Cough suppressants ineffective in children 408
No antibiotics necessary for lower respiratory infection 409
Chest cold instead of bronchitis decreases unnecessary antibiotic use 410
Pelargonium effective for acute bronchitis symptoms 411
Single oral dose dexamethasone effective for even mild croup 412
Data on treating bronchiolitis severely limited 413
Pneumonia 414
Blood cultures add little to pneumonia care 414
Antibiotics with atypical bacteria coverage unnecessary 415
Outpatient = inpatient for low-risk patients with pneumonia 416
Antibiotic choice makes little difference in community-acquired pneumonia 417
Pneumonia: 3 days of antibiotics for uncomplicated course 418
Amoxicillin for 3 days effective for pediatric pneumonia 419
7-day levofloxacin slightly better than 1-day azithromycin for pneumonia 420
Skin Diseases 421
Acne vulgaris 421
Milk intake correlates with increased risk of acne in women 421
Dapsone gel effective for acne vulgaris treatment 422
Dermatitis 423
Effective prevention and treatment of contact dermatitis 423
Immunosuppressives = steroids for atopic dermatitis 424
Once-daily topical steroid dosing just as effective for atopic eczema 425
Herpes zoster 426
Herpes zoster vaccine safe and effective for older adults 426
Tricyclics drug of choice for post-herpetic neuralgia 427
Melanoma 428
Melanoma incidence really not rising 428
Lifetime risk of mole transforming to melanoma very low 429
0.7% of congenital melanocytic nevi become malignant 430
Dermoscopy with validated criteria more sensitive than unaided eye 431
Other skin problems 432
Effective methods for preventing pressure ulcers 432
Duct tape seems effective for warts 433
Effective treatments for rosacea 434
Surgery + Procedures 435
Cancer 435
Larger margins better in melanoma 2 mm thick 435
Radical prostatectomy improves outcomes in symptom-detected
prostate cancer 436
Implantable defibrillators 437
Implantable defibrillators are not effective post-MI 437
Implantable defibrillators reduce mortality in NYHA Class li heart failure 438
Minor procedures 439
Small punch biopsies don t require sutures 439
Suturing of hand lacerations not necessary 440
Sterile gloves not necessary for laceration repair 441
Hot water (45 C) immersion best for jellyfish, man-of-war stings 442
Orthopeidcs and sports medicine 443
Surgery better than no surgery for spinal stenosis 443
Knee taping useful for osteoarthritis pain 444
Arthroscopy ineffective for osteoarthritis of knee 445
Extracorporeal shock wave therapy is ineffective for tennis elbow 446
Tennis elbow: injection better short-term, worse long-term 447
Otitis media 448
Tubes marginally effective in otitis media with effusion 448
Early tympanostomy tubes do not improve outcomes after 3 or more years 449
Prompt tympanostomy tube insertion doesn t improve 9year outcomes 450
Preoperative care 451
Beta-blockade reduces cardiac events in major noncardiac surgery 451
High-risk but not low-risk patients benefit from perioperative beta-blockade 452
Smoking cessation 6-8 weeks before surgery reduces complications 453
Vascular surgery and procedures 454
Better outcomes with CABC than PCI with stent for 2,3 vessel disease 454
Routine invasive strategy may be preferred for ACS 455
In ACS, 5years of invasive tx decreases Ml but not all cause mortality
(FRISC-II) 456
CABC not helpful before AAA or peripheral vascular surgery 457
EVAR worse than open repair of AAA (EVAR Trial 1) 458
Bypass = angioplasty for severe leg ischemia, but costs more (BASIL) 459
Endarterectomy best within 2 weeks of stroke or TIA 460
Carotid stent inferior to carotid endarterectomy 461
Routine use of vena cava filters doesn t reduce mortality 462
Systems of Care 463
Care of children 463
School-based violence prevention programs not proved 463
Risk scoring system predicts mortality in pediatric ICU 464
Parent satisfaction okay with no treatment of AOM 465
Parents prefer shared decision-making for AOM 466
Critical care 467
Intensive insulin only helpful if MICU stay 3 days or longer 467
Normal saline similar to 4% albumin in ICU fluid resuscitation 468
No benefit from pulmonary artery catheters for critically ill patients 469
Pulmonary artery catheters: no harm, no benefit (PAC-Man) 470
Door-to-balloon time important in STEMI 471
Prescribing practices 472
Pharmaceutical ads are often inaccurate 472
Prescribing antibiotics does not save time 473
Delayed prescription for AOM reduces unnecessary antibiotics 474
Delayed prescriptions for URIs reduce antibiotic use 475
Process of care 476
Quality of care not related to spending 476
Disclosure of errors preferred by patients 477
Hypertension follow-up: 3 months = 6 months 478
Watchful waiting acceptable option for inguinal hernia 479
Self-monitoring 480
Self-monitoring of anticoagulation safe, effective 480
Self-monitoring anticoagulation superior at preventing venous
thromboembolic events 481
Urology 482
Dysuria and urinary tract infection 482
Immediate- and extended-release ciprofloxacin similar for UTI 482
Treating negative dipstick dysuria decreases symptoms 483
Incontinence 484
Urinary incontinence diagnosis with 3 questions 484
HRT increases risk of stress, urge urinary incontinence 485
PT cures postpartum stress incontinence 486
No long-term continence with pelvic floor muscle training 487
Fewer complications with condom than Foley catheters 488
Nephrolithiasis 489
Tamsulosin effective for renal colic 489
Renal colic: NSAIDs more effective, less noxious than opioid analgesics 490
Medications help passage of kidney stones 491
Prostate cancer 492
Finasteride of mixed benefit in preventing prostate cancer 492
Prostate cancer screening every 4 years as good as annually 493
False-positive PSA associated with increased worry, fears 494
Elevated PSA should be confirmed before biopsy 495
Glossary 496
Index 498
|
| adam_txt |
Contents
Preface xxi
Taking an Evidence-Based Approach to the Care of Patients xxii
How to Become an Information Master: Feeling Good about NOT
Knowing Everything xxvii
InfoPOEMs (Patient-Oriented Evidence that Matters) 1
Cancer 3
Breast cancer 3
Most women with breast cancer have no risk factors 3
Raloxifene reduces breast cancer risk (CORE) 4
Raloxifene and tamoxifen equally effective in reducing breast cancer risk 5
Raloxifene decreases breast cancer risk, no effect on cardiovascular disease
risk (RUTH) 6
MRI more accurate than mammogram in high-risk patients 7
MRI more sensitive than mammography in high-risk women (MARIBS) 8
Digital mammography more sensitive for younger women 9
Mammography results in overdiagnosis 10
Annual mammography starting at 40 doesn't lower breast cancer mortality 11
Gynecologic cancers 12
Many unnecessary Pap smears are performed after hysterectomy 12
Specific HPV strains are associated with cervical cancer risk 13
Vaccine effective against HPV 14
Bivalent vaccine against HPV effective for 4.5 years 15
Liquid-based not better than conventional Pap 16
Endometrial sampling adequate for diagnosing endometrial cancer 17
Melanoma 18
Melanoma incidence really not rising 18
Lifetime risk of mole transforming to melanoma very low 19
0.7% of congenital melanocytic nevi become malignant 20
Dermoscopy with validated criteria more sensitive than unaided eye 21
Larger margins better in melanoma 2mm thick 22
Prevention and screening 23
Antioxidants don't prevent Cl cancers, and may increase overall mortality 23
Vitamin E doesn't lower women's risk of cardiovascular disease or cancer 24
Antioxidants don't prevent colorectal cancer 25
Mammography, FOBT and CXR don't reduce all-cause mortality 26
Spiral CT detects early lung cancer, but screening use is premature 27
Cancer linked to some diabetes treatments 28
Prostate cancer 29
Finasteride of mixed benefit in preventing prostate cancer 29
Prostate cancer screening every 4 years as good as annually 30
False-positive PSA associated with increased worry, fears 31
Elevated PSA should be confirmed before biopsy 32
Radical prostatectomy improves outcomes in symptom-detected prostate cancer 33
Cardiology 34
Acute myocardial infarction and acute coronary syndromes 34
Early metoprolol in acute Ml: no benefit, possible harm (COMMIT; CCS-2) 34
Insulin/dextrose infusion ineffective in AMI (HI-5) 35
Early initiation of statins following ACS does not improve outcomes 36
Antibiotics not effective in acute coronary syndromes 37
ABCDE approach to non-ST-segment elevation ACS 38
Door-to-balloon time important in STEMI 39
Routine invasive strategy may be preferred for ACS 40
Intensive medical tx + selective PCI preferred for non-ST ACS 41
Invasive tx slightly better in non-ST-elevation ACS (RITA3) 42
In ACS, 5years of invasive tx decreases Ml but not all cause mortality (FRISC-II) 43
Captopril = losartan for reducing all-cause mortality after Ml 44
Captopril better than valsartan or combination post-MI 45
Implantable defibrillators are not effective post-MI 46
Anticoagulation management 47
Start warfarin at lOmg faster for outpatient anticoagulation 47
Use an algorithm to start warfarin in older patients 48
Self-monitoring of anticoagulation safe, effective 49
Self-monitoring anticoagulation superior at preventing venous
thromboembolics events 50
INR 1.5-1.9 less effective than 2.0-3.0 for idiopathic DVT 51
Oral vitamin K works faster than subcutaneous 52
Oral vitamin K effective for warfarin overdose 53
Atrial fibrillation 54
Clinical decision rules accurately predict stroke risk in atrial fibrillation 54
Thromboembolism just as likely with atrial flutter 55
Warfarin prevents more strokes than clopidorel + ASA in atrial fibrillation (ACTIVE) 56
Ximelagatran effective in preventing stroke in atrial fibrillation 57
Quality of life with rate or rhythm control in atrial fibrillation (AFFIRM) 58
Rate control better than rhythm control in atrial fibrillation (AFFIRM) 59
Amiodarone sotalol placebo for maintaining NSR in atrial fibrillation (SAFE-T) 60
Coronary artery disease 61
Mediterranean diet associated with lower all cause mortality 61
Coffee does not increase risk of developing CAD 62
Vitamin E has no effect on cardiovascular disease 63
Lowering homocysteine does not reduce cardiovascular disease (HOPE 2) 64
Omega 3 fatty acids do not affect mortality 65
Fotic acid supplementation does not reduce cardiovascular disease risk nor mortality 66
Fenofibrate doesn't prevent coronary events in DM (FIELD) 67
Optimal oral antiplatelet therapy for vascular disease 68
Clopidogrel + ASA no better than ASA alone for high-risk patients 69
Clopidogrel beneficial added to ASA, fibrinolytic in STEMI 70
Aspirin reduces risk of CV events, increases risk of bleeding 71
Aspirin + PPI safer than clopidogrel if history of Cl bleed 72
Electron beam tomography not helpful 73
Chest pain relief by NTC doesn't predict active CAD 74
Ranolazine adds little to maximum antianginal therapy (ERICA) 75
Better outcomes with CABC than PCI with stent for 2,3 vessel disease 76
Adding ACEI doesn't improve outcomes in stable angina w/nl LVEF (PEACE) 77
COX-2 inhibitors and heart disease 78
Rofecoxib increases risk of cardiovascular events 78
Celecoxib increases risk of cardiovascular complications 79
Rofecoxib, diclofenac and indomethacin increase risk of CVD 80
Heart failure 81
BNP improves outcomes in evaluation of dyspnea 81
BNP testing beneficial with CHF + pulmonary dx 82
Serial BNP levels predict risk of death and CHF after ACS 83
Higher BNP and N-ANP predict CV events 84
ARBs = ACEIs for all-cause mortality in heart failure 85
Optimal digoxin range for men 0.5 to 0.8ng/ml 86
Digoxin increases mortality in women with heart failure 87
Nesiritide for CHF may increase mortality risk 88
Implantable defibrillators reduces mortality in NYHA Class II heart failure 89
Hypertipidemia 90
Herbs may reduce cholesterol, no data on clinical outcomes 90
Statins prevent CAD 91
Cholesterol lowering cost-effective in high-risk elderly 92
Intensive lipid lowering of marginal benefit even if high-risk 93
Varying effects of lipid drugs on overall mortality 94
Statins equivalent for CVD prevention 95
Intensive lipid lowering with statins unnecessary with stable CAD (IDEAL) 96
Hypertension 97
JNC 7 report on prevention/evaluation/treatment of hypertension 97
Work stress has no meaningful effect on blood pressure 98
Pseudoephedrine has a minimal effect on blood pressure 99
Habitual caffeine intake does not increase risk of hypertension in women 100
Home blood pressure monitoring valuable 101
Office measurements usually overestimate blood pressure 102
Hypertension follow-up: 3 months = 6 months 103
Patients with HTN + high lipids may benefit less from statins (ALLHAT) 104
Excessive lowering of blood pressure causes more harm than good 105
Diuretics clearly first line agent for HTN (ALLHAT) 106
Meta-analysis supports diuretics as first line for HTN 107
Outcomes for thiazides similar 108
ACEI better than diuretic in older men for hypertension 109
Atenolol of questionable efficacy for HTN 110
Beta-blockers placebo, not other drugs, in preventing HTN complications 111
Renal function similarly affected by antihypertensives (ALLHAT) 112
Peripheral vascular disease and aneurysm 113
Screening program for abdominal aortic aneurysm ineffective 113
Fewer aneurysm deaths but not overall deaths with AAA screening 114
CABG not helpful before AAA or peripheral vascular surgery 115
EVAR worse than open repair of AAA (EVAR Trial 1) 116
Bypass = angioplasty for severe leg ischemia, but costs more (BASIL) 117
Pulmonary hypertension 118
Sildenafil effective for primary pulmonary hypertension 118
Sildenafil = bosentan in pulmonary hypertension (SERAPH) 119
Thrombophilias 120
Testing for prothrombotic defects not necessary after first DVT 120
Management of antiphospholipid antibody syndrome 121
Venous thromboembolism 122
Fixed-dose, subcutaneous, unfractionated heparin effective for VTE 122
Compression stockings prevent post-thrombotic syndrome 123
Routine use of vena cava filters doesn't reduce mortality 124
At least 6 months of anticoagulation optimal to prevent recurrent VTE 125
LMWH better than warfarin in preventing recurrent DVT in cancer patients 126
Venous thromboembolism diagnosis and prognosis 127
Best tests to rule in, rule out PE 127
Clinical prediction rules accurate for PE diagnosis 128
Validated algorithm for evaluating suspected PE 129
Optimal algorithm for evaluating suspected DVT 130
Multidetector CT accurate for PE, but requires clinical context 131
Negative CT scan to rule out PE equal to angiography 132
Determining major bleeding risk with warfarin for DVT 133
D-dimer useful for excluding DVT and PE 134
D-dimer 250ng/mL predicts low risk of VTE recurrence 135
Care of Infants and Children 136
ADHD 136
Restricted diet improves parental perception of hyperactive behavior 136
Stimulants similarly effective for ADHD 137
Responders to atomoxetine do welt with lower doses 138
Anemia 139
Anemia not prevented by iron in infants 139
Anemia doesn't predict iron deficiency among toddlers 140
Asthma 141
Long-term budesonide does not effect adrenal function in children 141
Amoxicillin for 3 days effective for pediatric pneumonia 142
Educational programs effective for young asthmatics 143
Diarrhea 144
Nitazoxanide reduces rotavirus duration in hospitalized kids 144
Oral rotavirus vaccines safe and effective 145
Intense diet-behavior-physical activity effective for obese children 146
Evidence lacking for milk's benefit in children 147
Prevention 148
Vaccine exposure does not increase risk of infectious disease hospitalization 148
Dental restoration with amalgam (mercury) safe in children 149
School-based violence prevention programs not proved 150
Otitis media 151
Delayed prescription for AOM reduces unnecessary antibiotics 151
Parent satisfaction okay with no treatment of AOM 152
Parents prefer shared decision-making for AOM 153
Tubes marginally effective in otitis media with effusion 154
Early tympanostomy tubes do not improve outcomes after 3 or more years 155
Prompt tympanostomy tube insertion doesn't improve 9year outcomes 156
Other pediatric problems 157
Bed and pillow covers ineffective for allergic rhinitis 157
Risk scoring system predicts mortality in pediatric ICU 158
Petroleum jelly doesn't reduce recurrent pediatric epistaxis 159
Effective and ineffective interventions for infant colic 160
Respiratory infections and fever 161
Ear thermometry is unreliable in detecting fever 161
Acetaminophen, ibuprofen comparable for pain, fever in children 162
Cough suppressants ineffective in children 163
Delayed prescriptions for URIs reduce antibiotic use 164
Amoxicillin for 3 days effective for pediatric pneumonia 165
Sore throat 166
Herbal tea effective for symptoms of acute pharyngitis 166
Steroids provide brief relief of pain in mononucleosis 167
Echinacea purpurea ineffective for treating URI in kids 168
Complementary and Alternative Medicine 169
Diarrhea 169
Yogurt prevents antibiotic-associated diarrhea 169
Probiotics helpful for antibiotic-associated diarrhea 170
Probiotics effective in preventing acute diarrhea, but not traveler's diarrhea 171
Diet and exercise 172
Popular diets equally effective for losing weight 172
Mediterranean diet associated with lower all cause mortality 173
Omega 3 fatty acids do not affect mortality 174
Diet and exercise prevent diabetes in high-risk patients 175
Mental health problems 176
Restricted diet improves parental perception of hyperactive behavior 176
Variable support for CAM therapies for anxiety 177
Antioxidants do not prevent dementia 178
Lowering homocysteine with B vitamins doesn't improve
cognition 179
Vitamin E, donepezil ineffective for mild cognitive impairment 180
Light therapy as effective as fluoxetine for seasonal affective disorder 181
Musculoskeletal problems 182
Acupuncture effective for chronic back pain 182
Tai chi improves symptoms of osteoarthritis 183
Acupuncture effective for OA of the knee 184
Acupuncture ineffective for fibromyalgia 185
Acupuncture better than sham treatment for neck pain 186
Prevention of cancer 187
Vitamin E not helpful, perhaps harmful 187
Vitamin E doesn't lower women's risk of cardiovascular disease or cancer 188
Vitamin E has no effect on cardiovascular disease 189
Antioxidants don't prevent Gl cancers, and may increase overall mortality 190
Antioxidants don't prevent colorectal cancer 191
Green tea consumption is associated with reduced mortality 192
DHEA, testosterone not effective in aging patients 193
Lowering homocysteine does not reduce cardiovascular disease (HOPE 2) 194
Folic acid supplementation does not reduce cardiovascular disease risk
nor mortality 195
Herbs may reduce cholesterol, no data on clinical outcomes 196
Upper respiratory problems 197
Herbal tea effective for symptoms of acute pharyngitis 197
Petroleum jelly doesn't reduce recurrent pediatric epistaxis 198
Saline nasal irrigation effective for frequent sinusitis 199
Forcing fluids during a respiratory infection unsupported by studies 200
Zinc nasal gel reduces duration of common cold 201
Echinacea purpurea ineffective for treating URI in kids 202
Echinacea doesn't shorten or lessen cold symptoms 203
Women's health 204
Black cohosh ineffective for vasomotor symptoms 204
Acupuncture ineffective for hot flashes 205
Lactobacillus doesn't prevent post-antibiotic vaginitis 206
Immersion exercise reduces leg edema in pregnancy 207
Endocrinology 208
Diabetes 208
Diet and exercise prevent diabetes in high-risk patients 208
Treating prediabetes does not affect progression 209
Rosiglitazone delays developing diabetes mellitus (DREAM) 210
Hypertension control most important aspect of diabetes care 211
Fenofibrate doesn't prevent coronary events in diabetes mellitus (FIELD) 212
Home glucose monitoring makes little difference in type 2 diabetes 213
Rosiglitazone more likely to succeed as monotherapy clinical outcomes no better 214
ACE inhibitors beneficial in diabetics 215
ARB no better than ACEI for prevention of nephropathy progression 216
Pioglitazone ineffective in secondary prevention of macrovascular
complications (PROactive) 217
Cancer linked to some diabetes treatments 218
Duloxetine decreases pain of diabetic neuropathy 219
Obesity 220
Weight loss interventions have little effect on quality of life 220
Popular diets equally effective for losing weight 221
Intense diet-behavior-physical activity effective for obese children 222
Rimonabant minimally effective for weight loss 223
Topiramate beneficial for binge eating disorder with obesity 224
Bariatric surgery effective for morbid obesity 225
Eye, Ear, Nose and Throat 226
Allergic rhinitis 226
Bed and pillow covers ineffective for allergic rhinitis 226
Pollen blocker cream effective for allergic rhinitis 227
Montelukast alone ineffective for allergic rhinitis 228
Epistaxis 229
Petroleum jelly doesn't reduce recurrent pediatric epistaxis 229
Eye problems 230
Lutein improves vision with macular degeneration in men 230
Three indicators herald bacterial conjunctivitis in adults 231
Antibiotics for conjunctivitis decreases symptom duration 232
Diet high in beta carotene, vitamins C and E, and zinc may reduce risk of
macular degeneration 233
Otitis media 234
Parent satisfaction okay with no treatment of AOM 234
Parents prefer shared decision-making for AOM 235
Delayed prescription for AOM reduces unnecessary antibiotics 236
Tubes marginally effective in otitis media with effusion 237
Early tympanostomy tubes do not improve outcomes after 3 or more years 238
Prompt tympanostomy tube insertion doesn't improve 9year outcomes 239
Sinusitis 240
Saline nasal irrigation effective for frequent sinusitis 240
Intranasal steroids alone effective for acute uncomplicated sinusitis 241
Sore throat 242
Herbal tea effective for symptoms of acute pharyngitis 242
Steroids provide brief relief of pain in mononucleosis 243
URI 244
Gargling with water prevents colds 244
Delayed prescriptions for URIs reduce antibiotic use 245
Forcing fluids during a respiratory infection unsupported by studies 246
Zinc nasal gel reduces duration of common cold 247
Echinacea purpurea ineffective for treating URI in kids 248
Antibiotics slightly effective for purulent rhinitis 249
Echinacea doesn't shorten or lessen cold symptoms 250
Gastrointestinal Problems 251
Diarrhea and gastroenteritis 251
Yogurt prevents antibiotic-associated diarrhea 251
Probiotics helpful for antibiotic-associated diarrhea 252
Probiotics effective in preventing acute diarrhea, but not traveler's diarrhea 253
Nitazoxanide reduces rotavirus duration in hospitalized kids 254
Oral rotavirus vaccines safe and effective 255
Ondansetron effective for gastroenteritis with vomiting 256
Dyspepsia and gastrointestinal bleeding 257
Omeprazole 20mg = 40mg for primary care acid-related dyspepsia 257
Omeprazole, ranitidine effective for HP negative dyspepsia (CADET-HN) 258
4 drugs for 1 day eliminates H. pylori 259
Aspirin + PPI safer than clopidogrel if history of Cl bleed 260
Castroesophageal reflux disease 261
A PPI test does not improve diagnosis of CERD 261
Lifestyle changes of little benefit in CERD 262
All PPIs equivalent for treatment of CERD 263
Hepatobiliary disorders 264
Acetaminophen does not affect liver function in alcoholics 264
Evaluation of abnormal liver chemistries 265
Enteral nutrition preferred in pancreatitis 266
Antibiotic prophylaxis reduces mortality in hospitalized cirrhotics 267
Cynecology 268
Cervical and endometrial cancer 268
Many unnecessary Pap smears are performed after hysterectomy 268
Specific HPV strain are associated with cervical cancer risk 269
Vaccine effective against HPV 270
Bivalent vaccine against HPV effective for 4.5 years 271
Liquid-based not better than conventional Pap 272
Endometrial sampling adequate for diagnosing endometrial cancer 273
Infertility and contraception 274
Avoid nonoxynol-9 spermicides with less than 100g per dose 274
Metformin increases fertility in PCOS 275
Menopause 276
HRT with estrogen alone increases stroke, decreases fractures 276
Clonidine, gabapentin, and some SSRIs effective for hot flashes 277
Black cohosh ineffective for vasomotor symptoms 278
Acupuncture ineffective for hot flashes 279
HRT increases risk of stress, urge urinary incontinence 280
Vaginitis 281
Weekly fluconazole reduces recurrent candidiasis, though costly 281
Lactobacillus doesn't prevent post-antibiotic vaginitis 282
Hematology 283
Anemia 283
Anemia not prevented by iron in infants 283
Anemia doesn't predict iron deficiency among toddlers 284
Repeated blood testing causes anemia 285
Oral as good as IM vitamin B12 replacement 286
Thrombophilias 287
LMWH better than warfarin in preventing recurrent DVT in cancer patients 287
Testing for prothrombotic defects not necessary after first DVT 288
Management of antiphospholipid antibody syndrome 289
Infectious Disease 290
Prevention 290
Oral rotavirus vaccines safe and effective 290
Acellular pertussis vaccine 63% to 92% effective 291
Vaccine exposure does not increase risk of infectious disease hospitalization 292
Antibacterial household products don't reduce infectious symptoms 293
Prescribing practices 294
Cephalosporins often safe in PCN-allergic patients 294
Prescribing antibiotics does not save time 295
Delayed prescription for AOM reduces unnecessary antibiotics 296
Delayed prescriptions for URIs reduce antibiotic use 297
Respiratory infections 298
Flu shots are effective in elderly 298
Useful signs and symptoms for diagnosis of influenza 299
Steroids provide brief relief of pain in mononudeosis 300
Kidney Diseases 301
Diabetic nephropathy 301
ACE inhibitors beneficial in diabetics 301
ARB no better than ACEI for prevention of nephropathy progression 302
Gout 303
Meat, seafood, and little dairy are risk factors for gout 303
Febuxostat = allopurinol for gout prophylaxis 304
Renal failure 305
Low-dose dopamine ineffective for acute renal failure 305
Furosemide doesn't prevent acute renal failure 306
Urinary tract infection and dysuria 307
Treating negative dipstick dysuria decreases symptoms 307
Immediate- and extended-release ciprofloxacin similar for UTI 308
Musculoskeletal Problems 309
Back and neck pain 309
Acupuncture effective for chronic back pain 309
Surgery better than no surgery for spinal stenosis 310
Acupuncture better than sham treatment for neck pain 311
Useful treatments for fibromyalgia syndrome 312
Acupuncture ineffective for fibromyalgia 313
Degenerative joint disease 314
Acetaminophen = celecoxib in DJD 314
Knee taping useful for osteoarthritis pain 315
Tai chi improves symptoms of osteoarthritis 316
Acupuncture effective for OA of the knee 317
Rofecoxib increases risk of cardiovascular events 318
Celecoxib increases risk of cardiovascular complications 319
Rofecoxib, diclofenac and indomethacin increase risk of CVD 320
Rofecoxib cardiovascular risks known in 2000 321
Arthroscopy ineffective for osteoarthritis of knee 322
Obesity does not effect 5-year knee replacement outcomes 323
Osteoporosis and fractures 324
Monthly vitamin D prevents fractures 324
Calcium/vitamin D effective for prevention of first fracture 325
Calcium/vitamin D not effective for secondary prevention of fracture (RECORD) 326
1000mg calcium/400 IU vit D not very effective for fracture prevention (WHI) 327
HRT with estrogen alone increases stroke, decreases fractures 328
Long-term PPI use increases hip fracture risk 329
Most women quickly stop taking bisphosphonates 330
Evidence lacking for milk's benefit in children 331
Folate and vitamin B12 lowers fracture risk after stroke 332
Falls prevented in elderly by formal assessment or exercise program 333
Early mobilization better for acute limb injuries 334
Other musculoskeletal problems 335
Nonsurgical treatment effective for carpal tunnel 335
PET scan best in chronic osteomyelitis diagnosis 336
Extracorporeal shock wave therapy is ineffective for tennis elbow 337
Tennis elbow: injection better short-term, worse long-term 338
Neurology 339
Headache 339
Metoclopramide (Reglan) effective in migraine 339
Intranasal zolmitriptan effective for cluster headaches 340
Specific headache criteria useful for migraine diagnose, neuroimaging 341
Herpes zoster 342
Herpes zoster vaccine safe and effective for older adults 342
Tricyclics drug of choice for post-herpetic neuralgia 343
Insomnia 344
Melatonin effective for some sleep disorders 344
Cognitive therapy superior to zopiclone for insomnia 345
Syncope and vertigo 346
Simple maneuvers can decrease vasovagal syncope episodes 346
Steroid effective for vestibular neuritis, valacyclovir is not 347
Stroke 348
ASA prevents stroke, not Ml, in women 348
ASA + dipyridamole better than ASA for cerebral ischemia (ESPRIT) 349
Warfarin increases mortality in intracranial arterial stenosis 350
Lipid-lowering prevents stroke in patients with or without CHD 351
High-dose atorvastatin reduces recurrent stroke, not mortality
(SPARCL) 352
ABCD rule predicts 7-day stroke risk in TIA 353
ABCD rule predicts 7- and 30-day stroke risk in patients with TIA 354
Eight clinical findings distinguish stroke from stroke mimics 355
Noninvasive carotid imaging can replace invasive imaging 356
Three percent of TIA patients have a stroke within 30 days (BASIC) 357
Endarterectomy best within 2 weeks of stroke or TIA 358
Carotid stent inferior to carotid endarterectomy 359
PEG tubes worsen quality of life in stroke (FOOD) 360
Pregnancy Care 361
Labor management 361
Fetal pulse oximetry does not reduce operative delivery 361
Suction before delivery of shoulders doesn't prevent meconium aspiration 362
VBAC with prior vaginal delivery safer than cesarean 363
Prenatal care 364
Risk-based screening for CDM effective 364
Steroids effective for hyperemesis gravidarum 365
Immersion exercise reduces leg edema in pregnancy 366
Aspirin = enoxaparin for prevention of recurrent miscarriage 367
Preterm labor 368
Prenatal vaginal infection screening + treating reduces preterm delivery 368
Oral clindamycin for BV prevents prematurity 369
Psychology and Substance Abuse 370
ADHD 370
Restricted diet improves parental perception of hyperactive behavior 370
Stimulants similarly effective for ADHD 371
Responders to atomoxetine do well with lower doses 372
Antipsychotics and schizophrenia 373
Newer antipsychotics similar to older agents (CATIE) 373
Atypical antipsychotics minimally effective, poorly tolerated in
Alzheimer's disease 374
Older, newer antipsychotics both increase mortality in elderly 375
Anxiety and stress 376
Variable support for CAM therapies for anxiety 376
Work stress has no meaningful effect on blood pressure 377
Dementia 378
Antioxidants do not prevent dementia 378
Lowering homocysteine with B vitamins doesn't improve cognition 379
Reasoning training slows age-related functional decline 380
Statins not associated with decreased dementia 381
Vitamin E, donepezil ineffective for mild cognitive impairment 382
Drug therapy minimally effective for neuropsych symptoms of dementia 383
Minimal effect of cholinesterase inhibitors for Alzheimer's 384
Haloperidol shortens duration, intensity but not frequency of post-up delirium 385
Small increased risk of death with atypical antipsychotics for dementia 386
Older, newer antipsychotics both increase mortality in elderly 387
Depression 388
Two question screening for depression effective 388
No difference among new antidepressants 389
Alternative medications are similarly effective for depression treatment
failures (STAR*D) 390
Suicide rates equal regardless of antidepressant type 391
Antidepressant drugs increase suicidal behavior in children 392
Newer antidepressants increase suicidality in youths 393
Light therapy as effective as fluoxetine for seasonal affective disorder 394
Tobacco abuse 395
Smoking cessation 6-8 weeks before surgery reduces complications 395
12 weeks of varenicline is effective for smoking cessation 396
6 weeks of varenicline is also effective for smoking cessation 397
Respiratory Problems 398
Asthma 398
Educational programs effective for young asthmatics 398
Bed and pillow covers ineffective for asthma 399
Exhaled nitric oxide and sputum analysis useful for asthma diagnosis 400
Intermittent = continuous therapy for mild persistent asthma 401
Salmeterol + fluticasone better than fluticasone for asthma (COAL) 402
Don't double steroid dose in deteriorating asthma 403
Long-term budesonide does not effect adrenal function in children 404
COPD 405
Procalcitonin test can reduce antibiotic use in COPD 405
Corticosteroids benefit patients with moderate to severe COPD 406
Anticholinergics are better than beta-agonists in COPD treatment 407
Lower respiratory infections 408
Cough suppressants ineffective in children 408
No antibiotics necessary for lower respiratory infection 409
"Chest cold" instead of "bronchitis" decreases unnecessary antibiotic use 410
Pelargonium effective for acute bronchitis symptoms 411
Single oral dose dexamethasone effective for even mild croup 412
Data on treating bronchiolitis severely limited 413
Pneumonia 414
Blood cultures add little to pneumonia care 414
Antibiotics with atypical bacteria coverage unnecessary 415
Outpatient = inpatient for low-risk patients with pneumonia 416
Antibiotic choice makes little difference in community-acquired pneumonia 417
Pneumonia: 3 days of antibiotics for uncomplicated course 418
Amoxicillin for 3 days effective for pediatric pneumonia 419
7-day levofloxacin slightly better than 1-day azithromycin for pneumonia 420
Skin Diseases 421
Acne vulgaris 421
Milk intake correlates with increased risk of acne in women 421
Dapsone gel effective for acne vulgaris treatment 422
Dermatitis 423
Effective prevention and treatment of contact dermatitis 423
Immunosuppressives = steroids for atopic dermatitis 424
Once-daily topical steroid dosing just as effective for atopic eczema 425
Herpes zoster 426
Herpes zoster vaccine safe and effective for older adults 426
Tricyclics drug of choice for post-herpetic neuralgia 427
Melanoma 428
Melanoma incidence really not rising 428
Lifetime risk of mole transforming to melanoma very low 429
0.7% of congenital melanocytic nevi become malignant 430
Dermoscopy with validated criteria more sensitive than unaided eye 431
Other skin problems 432
Effective methods for preventing pressure ulcers 432
Duct tape seems effective for warts 433
Effective treatments for rosacea 434
Surgery + Procedures 435
Cancer 435
Larger margins better in melanoma 2 mm thick 435
Radical prostatectomy improves outcomes in symptom-detected
prostate cancer 436
Implantable defibrillators 437
Implantable defibrillators are not effective post-MI 437
Implantable defibrillators reduce mortality in NYHA Class li heart failure 438
Minor procedures 439
Small punch biopsies don't require sutures 439
Suturing of hand lacerations not necessary 440
Sterile gloves not necessary for laceration repair 441
Hot water (45 C) immersion best for jellyfish, man-of-war stings 442
Orthopeidcs and sports medicine 443
Surgery better than no surgery for spinal stenosis 443
Knee taping useful for osteoarthritis pain 444
Arthroscopy ineffective for osteoarthritis of knee 445
Extracorporeal shock wave therapy is ineffective for tennis elbow 446
Tennis elbow: injection better short-term, worse long-term 447
Otitis media 448
Tubes marginally effective in otitis media with effusion 448
Early tympanostomy tubes do not improve outcomes after 3 or more years 449
Prompt tympanostomy tube insertion doesn't improve 9year outcomes 450
Preoperative care 451
Beta-blockade reduces cardiac events in major noncardiac surgery 451
High-risk but not low-risk patients benefit from perioperative beta-blockade 452
Smoking cessation 6-8 weeks before surgery reduces complications 453
Vascular surgery and procedures 454
Better outcomes with CABC than PCI with stent for 2,3 vessel disease 454
Routine invasive strategy may be preferred for ACS 455
In ACS, 5years of invasive tx decreases Ml but not all cause mortality
(FRISC-II) 456
CABC not helpful before AAA or peripheral vascular surgery 457
EVAR worse than open repair of AAA (EVAR Trial 1) 458
Bypass = angioplasty for severe leg ischemia, but costs more (BASIL) 459
Endarterectomy best within 2 weeks of stroke or TIA 460
Carotid stent inferior to carotid endarterectomy 461
Routine use of vena cava filters doesn't reduce mortality 462
Systems of Care 463
Care of children 463
School-based violence prevention programs not proved 463
Risk scoring system predicts mortality in pediatric ICU 464
Parent satisfaction okay with no treatment of AOM 465
Parents prefer shared decision-making for AOM 466
Critical care 467
Intensive insulin only helpful if MICU stay 3 days or longer 467
Normal saline similar to 4% albumin in ICU fluid resuscitation 468
No benefit from pulmonary artery catheters for critically ill patients 469
Pulmonary artery catheters: no harm, no benefit (PAC-Man) 470
Door-to-balloon time important in STEMI 471
Prescribing practices 472
Pharmaceutical ads are often inaccurate 472
Prescribing antibiotics does not save time 473
Delayed prescription for AOM reduces unnecessary antibiotics 474
Delayed prescriptions for URIs reduce antibiotic use 475
Process of care 476
Quality of care not related to spending 476
Disclosure of errors preferred by patients 477
Hypertension follow-up: 3 months = 6 months 478
Watchful waiting acceptable option for inguinal hernia 479
Self-monitoring 480
Self-monitoring of anticoagulation safe, effective 480
Self-monitoring anticoagulation superior at preventing venous
thromboembolic events 481
Urology 482
Dysuria and urinary tract infection 482
Immediate- and extended-release ciprofloxacin similar for UTI 482
Treating negative dipstick dysuria decreases symptoms 483
Incontinence 484
Urinary incontinence diagnosis with 3 questions 484
HRT increases risk of stress, urge urinary incontinence 485
PT cures postpartum stress incontinence 486
No long-term continence with pelvic floor muscle training 487
Fewer complications with condom than Foley catheters 488
Nephrolithiasis 489
Tamsulosin effective for renal colic 489
Renal colic: NSAIDs more effective, less noxious than opioid analgesics 490
Medications help passage of kidney stones 491
Prostate cancer 492
Finasteride of mixed benefit in preventing prostate cancer 492
Prostate cancer screening every 4 years as good as annually 493
False-positive PSA associated with increased worry, fears 494
Elevated PSA should be confirmed before biopsy 495
Glossary 496
Index 498 |
| any_adam_object | 1 |
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| dewey-full | 616.075 |
| dewey-hundreds | 600 - Technology (Applied sciences) |
| dewey-ones | 616 - Diseases |
| dewey-raw | 616.075 |
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| dewey-tens | 610 - Medicine and health |
| discipline | Medizin |
| discipline_str_mv | Medizin |
| format | Book |
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| illustrated | Not Illustrated |
| index_date | 2024-07-02T21:50:01Z |
| indexdate | 2024-07-09T21:20:37Z |
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| isbn | 0470178906 9780470178904 |
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| publishDate | 2007 |
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| spellingShingle | Essential evidence medicine that matters ; InfoPOEMs Evidence-Based Medicine Abstracts Evidence-based medicine |
| title | Essential evidence medicine that matters ; InfoPOEMs |
| title_auth | Essential evidence medicine that matters ; InfoPOEMs |
| title_exact_search | Essential evidence medicine that matters ; InfoPOEMs |
| title_exact_search_txtP | Essential evidence medicine that matters ; InfoPOEMs |
| title_full | Essential evidence medicine that matters ; InfoPOEMs David Slawson ... |
| title_fullStr | Essential evidence medicine that matters ; InfoPOEMs David Slawson ... |
| title_full_unstemmed | Essential evidence medicine that matters ; InfoPOEMs David Slawson ... |
| title_short | Essential evidence |
| title_sort | essential evidence medicine that matters infopoems |
| title_sub | medicine that matters ; InfoPOEMs |
| topic | Evidence-Based Medicine Abstracts Evidence-based medicine |
| topic_facet | Evidence-Based Medicine Abstracts Evidence-based medicine |
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