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POEMs

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POEMs: Lorazepam Added to Haloperidol Effective for Agitated Delirium in End-of-Life ...

Feb 15, 2018 - Using a single dose of lorazepam in combination with haloperidol decreases agitation in end-of-life patients with cancer who had persistent agitated delirium despite scheduled haloperidol. A recent POEM reported that haloperidol increases symptoms of distress in patients with cancer and...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0215/od4.html

POEMs: Routine Oxygen Supplementation After Acute Stroke Does Not Improve Functional ...

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

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

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

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

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

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

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

POEMs: Ibuprofen Plus Acetaminophen Equals Opioid Plus Acetaminophen for Acute Severe ...

Mar 1, 2018 - In adults presenting to the emergency department with acute extremity pain severe enough to warrant radiologic investigation, ibuprofen plus acetaminophen was equally effective in reducing pain intensity at two hours compared with three different opioid and acetaminophen combination ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0301/p348.html

POEMs: Ibuprofen and Morphine Provide Similar Post-op Pain Relief in Kids; Ibuprofen ...

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

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

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

POEMs: Minimal Effect of ERT on Sexual Function in Menopausal Women - 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

POEMs: Single-Dose Oral Dexamethasone Decreases Sore Throat Pain - American Family ...

Feb 15, 2018 - Sore throats are rarely fatal anymore, but there is really no such thing as just a sore throat. Whereas antibiotics have no analgesic activity, a single low dose of a corticosteroid such as oral dexamethasone—0.6 mg per kg for children at least five years of age and up to 10 mg for ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0215/od1.html

POEMs: Light Therapy Improves Behavioral Disturbances, Sleep, Depression in Older ...

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

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

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

POEMs: No Effect on Mortality with Oxygen Therapy in Nonhypoxemic Patients with ...

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

POEMs: 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

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

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

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

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

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

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

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

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

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

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

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

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

POEMs: Transdermal Estrogen and Progestogen Most Effective to Reduce Menopausal ...

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

POEMs: Corticosteroid Injections Ineffective for Knee Osteoarthritis - American Family ...

Sep 15, 2017 - This well-done study found that regular three-month intra-articular injections of triamcinolone for two years resulted in no significant difference in pain and function assessments compared with saline. However, a significant increase in cartilage loss and damage did occur in patients ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0915/p406.html

POEMs: Treatment of Subclinical Hypothyroidism Ineffective in Older Adults - American ...

Oct 15, 2017 - Treatment of patients with a minimally elevated thyrotropin (thyroid-stimulating hormone) level did not result in any improvement in symptoms. If patients present with a thyrotropin level between 4.6 and 10 mIU per L, repeat the test because the levels often normalize (this occurred in ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1015/od3.html

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

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

POEMs: YEARS Clinical Decision Tool Decreases CTA in Patients with Suspected Pulmonary ...

Nov 15, 2017 - In this study, using a simplified algorithm in patients with suspected pulmonary embolism can safely decrease the number of CTAs.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1115/od3.html

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