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POEMs

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POEMs: Cervical Treatment Associated with Adverse Obstetric Outcomes - American Family ...

Dec 1, 2016 - Cervical treatments for dysplasia and early cervical carcinoma are associated with subsequent risk of preterm birth. Excisional treatments carry higher risk than ablative treatments, and multiple treatments carry higher risk than single treatments. The frequency and severity of ...

American Family Physician : POEMs

http://www.aafp.org/afp/2016/1201/p933a.html

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

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

POEMs: Step-by-Step Approach to Ruling Out Infant Infection Is Accurate - American ...

Dec 1, 2016 - The Step-by-Step approach, using a basic physical examination and readily available urine and blood tests (without lumbar puncture; see the Synopsis section), can successfully identify low-risk infants younger than 90 days who will not need empiric antibiotic treatment and lumbar ...

American Family Physician : POEMs

http://www.aafp.org/afp/2016/1201/p933.html

POEMs: Larger Bottles Associated with Greater Weight in Infants - American Family ...

Dec 1, 2016 - In nonbreastfed infants, using large bottles (at least 6 oz [180 mL]) to feed infants two months of age was associated with greater weight gain by six months of age. The authors did not report adverse effects associated with bottle size. This is an interesting study that suggests that ...

American Family Physician : POEMs

http://www.aafp.org/afp/2016/1201/p936.html

POEMs: Hypertensive Urgency Not Really an Urgent Problem - American Family Physician

Nov 1, 2016 - It seems that rapid treatment of patients with hypertensive urgency is unsuccessful and unnecessary. In this study of almost 60,000 patients, 80% did not have controlled blood pressure (less than 140/90 mm Hg) after one month of treatment, including patients who were hospitalized. On ...

American Family Physician : POEMs

http://www.aafp.org/afp/2016/1101/p750a.html

POEMs: Getting an Infant to Sleep: Graduated Extinction and Sleep Fading are Effective ...

Nov 1, 2016 - This study found that graduated extinction (increasing intervals between comforting the infant) and sleep fading (putting the child to bed progressively later until the parent finds the sweet spot) are both effective at decreasing sleep latency and the number of awakenings and ...

American Family Physician : POEMs

http://www.aafp.org/afp/2016/1101/p750.html

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

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

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

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

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

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

POEMs: Third-Generation Oral Contraceptives Associated with Greater Risk of PE, Stroke,...

Oct 15, 2016 - Although there is risk with any current oral contraceptive combination, those that contain lower doses of estrogen, and levonorgestrel instead of desogestrel or gestodene, are associated with the least risk of ischemic stroke, myocardial infarction (MI), or pulmonary embolism (PE). ...

American Family Physician : POEMs

http://www.aafp.org/afp/2016/1015/p663.html

POEMs: Procalcitonin Guidance Safely Decreases Antibiotic Use in Critically Ill ...

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

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

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

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

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

POEMs: Low-Dose Morphine Less Effective Than Diclofenac or Acetaminophen for Renal ...

Oct 15, 2016 - This is a good example of how a well-done study can lead to erroneous conclusions. The comparator most likely to be effective here—titrated morphine—was used at a low dose and found to be less effective than intramuscular diclofenac or intravenous paracetamol (acetaminophen).

American Family Physician : POEMs

http://www.aafp.org/afp/2016/1015/p665.html

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

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

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

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

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

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

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

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

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

POEMs: Inhaled Fluticasone-Salmeterol Better Than Fluticasone Alone for Moderate to ...

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

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

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

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

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

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

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

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

POEMs: Chondroitin/Glucosamine Equal to Celecoxib for Knee Osteoarthritis - 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

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

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

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

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

POEMs: Knee Surgery Does Not Reduce Knee Catching or Locking in Patients with Meniscal ...

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

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

POEMs: Mediterranean Diet Produces Moderate Weight Loss - 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

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

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

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

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

POEMs: No Reduction in Readmissions with Telemonitoring, Coaching for Patients with ...

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

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

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

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

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

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