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Do Not Change Antidepressant Treatment Early Based on a Lack of Response - POEMs - ...

Feb 15, 2020 - Do not be in a hurry to change treatment in patients with severe depression who do not respond to treatment within the first two weeks. Early response to treatment predicts eventual response or remission, but a lack of early response does not predict treatment failure.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0215/p250.html

Increased Readmissions and Adverse Events with Intensification of Antihypertensive ...

Feb 15, 2020 - The intensification of antihypertensive regimens on discharge in older adults hospitalized for noncardiac conditions is associated with an increased risk of readmission (number needed to harm [NNH] = 27) and medication-related serious adverse events (NNH = 63) within 30 days.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0215/p248a.html

Topical Interventions Improve Outcomes After Cryosurgery for Actinic Keratosis - POEMs ...

Feb 15, 2020 - Based on a review of low-quality evidence, adding a topical intervention after cryosurgery for actinic keratosis improves the likelihood of complete clearance from 46% to 79% (number needed to treat = 3).

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0215/p249.html

No Benefit, Longer Hospital Stay with Treatment of Asymptomatic Bacteriuria - POEMs - ...

Feb 15, 2020 - Inappropriate treatment of asymptomatic bacteriuria is common in hospitalized patients. Older patients, those with dementia or acutely altered mental status, and those with abnormal urinalysis results are more likely to be treated with antibiotics.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0215/p248.html

C-Reactive Protein Guidance Safely Reduces Antibiotic Use in Patients with Acute ...

Jan 1, 2020 - CRP guidance, regarding the likelihood that antibiotics will be helpful for patients with acute exacerbation of COPD, safely reduces antibiotic use (number needed to treat = 5).

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0101/p54.html

Fasting and Nonfasting Lipid Levels Similarly Predict Cardiovascular Disease Risk - ...

Jan 1, 2020 - Guidelines recommend checking lipid levels in nonfasting patients. They are easier to obtain and are equally predictive of subsequent cardiac events. Although triglyceride levels may be higher in nonfasting patients, cholesterol levels will be similar whether the patient was fasting or ...

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0101/p53.html

Addition of Steroids Improves Outcomes in Children and Adults with CAP - POEMs - ...

Jan 1, 2020 - Adding corticosteroid treatment to the management of CAP is beneficial for children and adults. Treatment decreases clinical failures, time in the hospital, and the risk of death in adults with severe pneumonia.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0101/p55.html

Adding Ultrasonography to Mammography Increases False-Positive Findings Without an ...

Jan 1, 2020 - Adding ultrasonography to screening mammography in women younger than 50 years at low, intermediate, or high breast cancer risk is not associated with an increase in breast cancer detection. It is associated with increased unnecessary biopsy recommendations and results in more frequent ...

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0101/p53a.html

Baloxavir Reduces Symptom Duration Similar to Oseltamivir, Primarily Within 24 Hours of...

Dec 15, 2019 - Baloxavir has similar efficacy to oseltamivir (Tamiflu) (33-hour reduction in duration of symptoms compared with placebo) and, like oseltamivir, is most effective when given within 24 hours of the onset of symptoms.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1215/od4.html

One Month of Dual Antiplatelet Therapy Followed by Clopidogrel Alone is Superior to 12 ...

Dec 15, 2019 - This study found that one month of dual antiplatelet therapy (aspirin plus clopidogrel or prasugrel [Effient]) followed by clopidogrel monotherapy for up to five years is both noninferior and superior to 12 months of dual antiplatelet therapy followed by aspirin for up to five years for...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1215/od5.html

Platelet-Rich Plasma is Equal to Saline for Patients with Patellar Tendinopathy - POEMs...

Dec 15, 2019 - In this study, platelet-rich plasma injections were no better than saline injections in improving pain or activity in patients with patellar tendinopathy. It did not matter whether the plasma was leukocyte rich or leukocyte poor.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1215/od2.html

Augmentation of Antidepressant Treatment Offers Little Benefit - POEMs - American ...

Dec 15, 2019 - The available evidence that treatment-resistant depression (depression that is unresponsive to two different treatments of adequate dose and length) responds well to augmentation treatment (i.e., adding psychotherapy, lithium, or aripiprazole [Abilify] to current treatment) is weak.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1215/od3.html

As-Needed Budesonide/Formoterol Similar to Maintenance Budesonide Plus SABA in Patients...

Nov 15, 2019 - In these patients with mild asthma (more than one-half used a short-acting beta-agonist [SABA] such as albuterol two or fewer times per week), as-needed use of a combined budesonide/formoterol (Symbicort) inhaler was as effective at preventing exacerbations as daily maintenance ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1115/p646a.html

Fully Automated Blood Pressure Measurement Is the Way to Go in the Office - POEMs - ...

Nov 15, 2019 - automated measurement aligns better with ambulatory blood pressure monitoring, the best predictor of cardiovascular events, than manual measurement; manual readings are an average 13.4 to 14.5 mm Hg (systolic) higher than daytime ambulatory or automated readings in patients with ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1115/p646.html

Platelet-Rich Plasma Injection Not Beneficial for Nonoperative Treatment of Rotator ...

Nov 15, 2019 - The review found no evidence that supports any additional benefit of platelet-rich plasma injections compared with various control interventions, including saline placebo, in the non-operative treatment of rotator cuff disease in adults.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1115/p647.html

Early Cardioversion No Better Than Delayed Cardioversion for Recent-Onset Symptomatic ...

Nov 15, 2019 - For patients presenting to the emergency department with recent-onset symptomatic atrial fibrillation, early cardioversion is no better than delayed cardioversion in achieving sinus rhythm within four weeks.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1115/p648.html

Oral Antibiotics Are Equal to IV Antibiotics for Serous Bone and Joint Infections - ...

Oct 1, 2019 - Oral antibiotics started within seven days of surgery for patients with a serious bone or joint infection are as safe and effective as six weeks of IV antibiotics.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1001/p441.html

Pneumatic Compression in Addition to Pharmacologic Thromboprophylaxis Does Not Further ...

Oct 1, 2019 - This study found no benefit to the addition of intermittent pneumatic compression to pharmacologic anticoagulation for the prevention of proximal DVT in critically ill patients.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1001/p440a.html

Laboratory-Based Prediction Model Can Rule Out Serious Bacterial Infections in Febrile ...

Oct 1, 2019 - In febrile infants up to 60 days of age, the combination of a normal urinalysis result, an absolute neutrophil count of less than 4,090 per mL (4.1 × 109 per L), and a serum procalcitonin level of less than 1.71 ng per mL is accurate at ruling out serious bacterial infections.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1001/p440.html

e-Cigarettes More Effective Than Nicotine Replacement for Cessation of Tobacco Use in ...

Oct 1, 2019 - Among adults who smoked a median of 15 cigarettes per day, those who were randomized to receive e-cigarettes were more likely to be abstinent at one year than those who received nicotine replacement (number needed to treat [NNT] = 12).

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1001/p442.html

Normal Vital Signs and Pulmonary Examination Results Rule Out CAP in Adults with Acute ...

Sep 15, 2019 - Community-dwelling adults who present to a primary care office with acute respiratory infection symptoms but normal vital signs and normal findings on a pulmonary examination have only a 0.4% likelihood of community-acquired pneumonia (CAP).

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0915/p375.html

Vitamin D Is Not Effective as Primary Prevention of Cardiovascular Disease or Cancer - ...

Sep 15, 2019 - Vitamin D supplementation does not prevent cardiovascular events or cancer in mostly nondiabetic adults (men 50 years and older, women 55 years and older).

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0915/p374.html

Omega-3 Fatty Acids Do Not Prevent Cancer or Cardiovascular Disease Events - POEMs - ...

Sep 15, 2019 - This is the second large, well-designed study (the first one included patients with diabetes mellitus; this one included patients without diabetes) that found no benefit from a 1-g daily dosage of marine n-3 fatty acid supplementation for the primary prevention of cardiovascular disease...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0915/p374a.html

Weak Evidence Supports Augmentation Therapy for Treatment-Resistant Depression - POEMs ...

Sep 15, 2019 - There is weak research to guide treatment decisions for patients who have not responded to two adequate courses of antidepressant treatment. One study of cognitive behavior therapy showed benefit over placebo.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0915/p376.html

5% Fluorouracil Is the Preferred Treatment for Actinic Keratoses - POEMs - American ...

Aug 15, 2019 - The use of topical 5% fluorouracil is most likely to result in successful elimination of actinic keratoses in a field on the head or face.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0815/p249a.html

Short-Term Clopidogrel Plus Aspirin Prevents Second Ischemic Stroke Better Than Aspirin...

Aug 15, 2019 - Combined treatment with clopidogrel and aspirin, started within 24 hours of the first event, will decrease the likelihood of a recurrent stroke in an additional 2% of patients compared with aspirin alone, with a slight increase in the risk of extra-cranial bleeding.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0815/p249.html

Dapagliflozin in High-Risk Type 2 Diabetes Reduces Hospitalization for Heart Failure ...

Aug 1, 2019 - The only cardiovascular benefit to treatment with dapagliflozin was a reduction in the likelihood of hospitalization; 125 patients would need to be treated for 10 years to prevent one hospitalization.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0801/p184.html

More Evidence Against Antibiotics for Acute Asthma Exacerbations - POEMs - American ...

Aug 1, 2019 - Antibiotics do not benefit patients hospitalized with an asthma exacerbation. Evidence from this study suggests worse outcomes with antibiotic use, including a longer hospital stay, higher costs, and greater risk of diarrhea.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0801/p185.html

Misoprostol Alone is Associated with High Rate of Successful First-Trimester Abortion -...

Jul 15, 2019 - Misoprostol alone was associated with a nearly 80% success rate in the first trimester of pregnancy on meta-analysis.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0715/p119.html

In Healthy Older Adults, Low-Dose Aspirin Increases All-Cause and Cancer-Specific ...

Jul 15, 2019 - The findings are completely unexpected. Although recent studies by this group and other groups of researchers have failed to find a cardiovascular benefit, likely because of better control of other cardiovascular risk factors, this study found increased all-cause mortality, primarily ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0715/p118a.html

Omega-3 Oil Does Not Reduce Serious Cardiovascular Events for Patients with Diabetes ...

Jul 15, 2019 - In this study, there was no significant difference in the likelihood of a composite vascular outcome or all-cause mortality in patients given an omega-3 fatty acid supplement compared with those given an olive oil placebo.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0715/p120.html

Vitamin D is Equal to Placebo for Preventing Cognitive Decline in African-American ...

Jul 15, 2019 - Is vitamin D more effective than placebo in preventing cognitive decline in African American women older than 65 years who have low serum vitamin D levels at baseline?

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0715/p118.html

Overview of New ACC/AHA Lipid Guidelines - POEMs - American Family Physician

Jun 1, 2019 - These updated guidelines, made without any input from primary care physicians who manage most patients with hyperlipidemia, are more complex than the 2013 guidelines and will likely lead to even more recommendations for statins, ezetimibe (Zetia), and PSK9 inhibitors.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0601/p716.html

Benefits and Harms for Low-Dose Aspirin in Patients with Diabetes Mellitus - POEMs - ...

Jun 1, 2019 - The 7,740 patients who took low-dose aspirin experienced 51 fewer vascular deaths, nonfatal myocardial infarctions, or nonfatal ischemic strokes; 29 fewer transient ischemic attacks; and 44 fewer revascularizations than patients who took placebo over a mean of 7.4 years.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0601/p718.html

Aspirin, Eicosapentaenoic Acid, and Placebo Equally Effective in Preventing Colorectal ...

Jun 1, 2019 - After 12 months, neither aspirin nor EPA, alone or in combination, are any better than placebo at preventing colorectal adenomas in patients with high-risk neoplasia.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0601/p717.html

Probiotic Ineffective for Treatment of Acute Gastroenteritis in Young Children - POEMs ...

Jun 1, 2019 - << Previous article Next article >> Jun 1, 2019 Issue POEMs Patient-Oriented Evidence That Matters Probiotic Ineffective for Treatment of Acute Gastroenteritis in Young Children Am Fam Physician. 2019 Jun 1;99(11):717-718. Clinical Question Is the probiotic Lactobacillus rhamnosus GG...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0601/p717a.html

Risk of GI Bleeding Highest with Rivaroxaban, Lower with Apixaban, and Lowest with PPI ...

May 15, 2019 - Among patients using oral anticoagulants alone, the risk of hospitalization for upper GI tract bleeding is highest with rivaroxaban (Xarelto) and lowest with apixaban (Eliquis).

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0515/od4.html

FIT Has Similar Yield as Colonoscopy for Colorectal Cancer and Advanced Adenoma Over 10...

May 15, 2019 - Over a 10-year period, the rates of detection of colorectal cancer (CRC) and advanced adenomas using FIT are similar to those seen in studies of screening colonoscopy. This does not prove that FIT reduces morbidity and mortality due to CRC as effectively as colonoscopy.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0515/od5.html

Limited Data: Deprescribing is Safe, But at the Risk of Symptom Recurrence - POEMs - ...

May 15, 2019 - The limited rigorous data on deprescribing suggest that many patients can safely stop unnecessary medication, but symptom relapse is significant.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0515/od2.html

Simple Clinical Prediction Rule Determines Risk of Heart Failure with Preserved ...

May 15, 2019 - A simple clinical prediction rule using noninvasive data can identify patients at low, moderate, and high risk for HFPEF.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0515/od3.html

Statins Ineffective for Primary Prevention of Cardiovascular Disease in Patients 75 ...

Apr 1, 2019 - In this retrospective study, statin treatment in patients 75 years or older without preexisting CVD did not change the likelihood of developing CVD or reduce any-cause mortality. However, patients 75 to 84 years of age with diabetes mellitus benefitted from treatment. These results ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0401/p461.html

Aspirin’s Benefits and Harms Are Less Clear for Primary Prevention in Moderate-Risk ...

Apr 1, 2019 - In this study, after five years of treatment, patients at a moderate risk of heart disease who took low-dose aspirin did not show a decrease in coronary events and all-cause mortality and had slightly more gastrointestinal bleeding.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0401/p459a.html

Guideline, with No Evidence, Suggests Annual Screening for Urinary Incontinence in ...

Apr 1, 2019 - The goal of screening is to identify a disorder before it becomes symptomatic if early treatment has the potential for greater benefit than waiting until symptoms are reported. Despite the failure to meet this definition, this guideline suggests annual screening of women for urinary ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0401/p459.html

No Reduction in Delirium with the Use of Haloperidol or Ziprasidone in Critically Ill ...

Apr 1, 2019 - For patients with acute respiratory failure or shock who develop delirium in the intensive care unit (ICU), the use of haloperidol or ziprasidone (Geodon) does not reduce the duration of delirium. This trial was powered to detect at least a two-day difference in the duration of ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0401/p460.html

Gabapentin and Pregabalin Not Effective for Low Back Pain with or Without Radiculopathy...

Mar 15, 2019 - The use of anticonvulsants like gabapentin (Neurontin) for painful conditions has increased greatly in recent years. This review finds good evidence that these drugs are not an effective treatment for low back pain with or without radiculopathy, and are associated with an increased risk...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0315/od2.html

Increased Water Intake Decreases UTI Recurrence in Women - POEMs - American Family ...

Mar 15, 2019 - Drinking an additional 1.5 liters per day of water halved the recurrence of UTI in women with a history of at least three episodes per year.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0315/od3.html

Lorcaserin Is Safe, But Only Modestly Effective for Weight Loss - POEMs - American ...

Mar 15, 2019 - Lorcaserin, 10 mg twice daily, helps some patients lose 10% or more of their body weight (number needed to treat [NNT] = 10) and appears to be safe in terms of cardiovascular events.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0315/od4.html

Aspirin Plus a High-Dose PPI Prevents Death and Progression in Patients with Barrett ...

Mar 15, 2019 - In this study, patients with Barrett esophagus were less likely to die or develop esophageal cancer or high-grade dysplasia if they took high-dose esomeprazole (Nexium) alone or in combination with aspirin.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0315/od5.html

Chronic Sinusitis: Saline Irrigation Helps Somewhat; Steroid Does Not Add More Benefit ...

Feb 1, 2019 - This study showed that patients with chronic rhinosinusitis who continue to use a saline nasal wash (NeilMed) will often experience an improvement in symptoms that can be clinically meaningful, but the addition of the corticosteroid budesonide has yet to show an extra benefit.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0201/p188.html

Clopidogrel Plus Aspirin Provides More Net Benefit Than Aspirin Alone After Minor ...

Feb 1, 2019 - This study provides support for a strategy of adding clopidogrel to aspirin for the first week or so after a minor ischemic stroke or TIA because this is when the greatest benefit occurs. Harms were spread fairly evenly throughout the study period.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0201/p188a.html

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