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Thrombolysis for DVT: Has the Time Arrived? - AFP Journal Club - American Family Physician

Apr 1, 2015 - Catheter-directed thrombolysis for proximal DVT is experimental but may be considered in a patient with phlegmasia and resulting compartment syndrome.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2015/0401/p430.html

PPIs, Childhood Asthma, and the Problem of Therapeutic Creep - AFP Journal Club - ...

Mar 15, 2014 - The use of a therapy in patients one would intuitively think might benefit, but in whom no benefit has been documented, is called therapeutic creep. The use of proton pump inhibitors for poorly controlled asthma is an example of this phenomenon.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2014/0315/p476.html

The Use of Coronary Computed Tomography Angiography to Rule Out CAD in the ED - AFP ...

Nov 15, 2012 - Is coronary CTA good enough to allow for the safe discharge of low- to intermediate-risk patients with chest pain? Coronary CTA and standard care were equally effective at identifying a low-risk population. The test saved seven hospital hours, but at the expense of radiation exposure, ...

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2012/1115/p900.html

Antibiotics for Acute Otitis Media in Young Children: The Case of the Shifting End ...

Jan 15, 2012 - A discussion of why the conclusion of a high-profile study, which suggests that antibiotics are beneficial in children six to 23 months of age with acute otitis media, is incorrect.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2012/0115/p104.html

Subarachnoid Hemorrhage and the CT Scan - AFP Journal Club - American Family Physician

Sep 15, 2011 - Is CT sensitive enough to rule out subarachnoid hemorrhage? This study says yes, but rretrospective studies are inherently problematic. Normal head CT should be followed by a lumbar puncture.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2011/0915/p632.html

How Do Clinical Practice Guidelines Go Awry? - AFP Journal Club - American Family ...

Sep 15, 2012 - Many guidelines are dominated by recommendations from experts and are not based on sound clinical studies. The development of clinical practice guidelines needs to be transparent and devoid of commercial, financial, and political influences. Physicians should also be wary of outdated ...

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2012/0915/p514.html

Can CPOE Systems Decrease Use of Laboratory Studies and Control Costs? - AFP Journal ...

Sep 15, 2014 - Can computerized physician order entry systems decrease the use of laboratory studies? An intervention's durability (ability to provide sustained results) is important to consider before implementing the intervention based on a study's results.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2014/0915/p409.html

Pulmonary Embolism Rule-Out Criteria: A Clinical Decision Rule That Works - AFP Journal...

Jul 15, 2013 - A number of clinical decision rules have been released recently. The PERC rule is an example of one that works well because it was derived from a large number of patients, and it was internally and externally validated.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2013/0715/p98.html

Evidence to Guide Measles Immunization Recommendations - AFP Journal Club - American ...

May 15, 2014 - Although measles vaccination is rarely associated with fever and seizures in children, the benefits of immunization outweigh the risks. Parents should be encouraged to follow recommended immunization schedule and avoid the MMR and varicella combination vaccine.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2014/0515/p786.html

Does Delaying Complementary Foods Protect Children Against Allergic and Atopic ...

Dec 15, 2013 - Breastfeeding duration, rather than exclusivity, may be the most important factor in prevention of atopic diseases. Earlier introduction of foods commonly associated with allergies may help prevent allergic and atopic diseases, but these data are inconclusive.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2013/1215/p818.html

Does Screening Mammography Lead to Overdiagnosis of Invasive Breast Cancer? - AFP ...

Mar 15, 2013 - Implementation of a universal mammographic screening program leads to an increase in the diagnosis of invasive breast cancer, because of improved detection of clinically significant cancer and overdiagnosis.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2013/0315/p408.html

Is Rivaroxaban Noninferior to Standard Warfarin Therapy in Preventing Recurrent PE and ...

Jun 15, 2013 - A trial showing that one drug is noninferior to another does not mean that these drugs are equivalent. The noninferiority margin allows researchers to choose their own benchmark for what is considered a clinically significant difference between two drugs.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2013/0615/p872.html

Can ECG Rule Out ACS if Performed While the Patient Is Having Chest Pain? - AFP Journal...

Nov 15, 2010 - Is negative ECG performed while the patient is having chest pain good at ruling out acute coronary syndrome? Although this study says yes, other higher-quality studies say it does not rule out cardiac disease. Observational studies are not ideal for testing some hypotheses.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2010/1115/p1185.html

Antidepressants for Initial Treatment of Depression - AFP Journal Club - American ...

May 15, 2010 - Which antidepressants should be used for the initial treatment of depression? This quality multiple-treatment meta-analysis gives physicians a good starting point for choosing an antidepressant. Sertraline and escitalopram should be considered first-line agents whereas bupropion, ...

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2010/0515/p1205.html

Rivaroxaban vs. Warfarin for Stroke Prevention in Patients with Nonvalvular Atrial ...

Mar 15, 2012 - How does rivaroxaban compare with warfarin for stroke prevention in patients with nonvalvular atrial fibrillation? This study concluded that rivaroxaban is noninferior to warfarin. However, noninferiority trials do not meet the same rigorous design and statistical format of traditional ...

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2012/0315/p577.html

Is the San Francisco Syncope Rule Reliable? - AFP Journal Club - American Family Physician

Sep 15, 2009 - Can the San Francisco Syncope Rule successfully determine which patients can be safely discharged after an acute syncopal episode? External validation suggests that the sensitivity of the rule is lower than first reported. Physicians need to apply their clinical acumen and override the ...

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2009/0915/p558.html

Beta Blockers and Noncardiac Surgery: Why the POISE Study Alone Should Not Change Your ...

Mar 15, 2010 - Should we stop using beta blockers to prevent myocardial infarction in persons undergoing noncardiac surgery? The data remain inconclusive. Although the POISE study is an important contribution to the literature, it uses a protocol that is unrealistic and should not change current ...

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2010/0315/p717.html

Antibiotics for Acute Otitis Media in Young Children - AFP Journal Club - American ...

Nov 15, 2011 - Two studies aim to clarify the appropriate use of antibiotic treatment in young children with acute otitis media.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2011/1115/p1095.html

Donepezil to Manage Alzheimer Disease: New vs. Standard Dosing - AFP Journal Club - ...

Mar 15, 2011 - Does donepezil benefit patients with Alzheimer disease, and is the new dosage superior to the standard dosage? This study showed benefit, but the data are misleading.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2011/0315/p742.html

Clinical Significance of Meniscal Damage on Knee MRI - AFP Journal Club - American ...

May 15, 2011 - Can you make the assumption that, in a patient with knee pain, meniscal damage found on MRI is responsible for his or her symptoms? Meniscal findings on knee MRI do not correlate well with pain.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2011/0515/p1160.html

Choosing One PPI Treatment Over Another - AFP Journal Club - American Family Physician

Nov 1, 2007 - Is one PPI better than another? All PPIs are equally effective in equipotent dosages, and choice should be based on price.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2007/1101/p1273.html

Albuterol vs. Levalbuterol for Asthma Treatment in Children - AFP Journal Club - ...

May 1, 2008 - For children with acute asthma exacerbations, is levalbuterol better than albuterol? There is no difference between the medications in effectiveness or side effects.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2008/0501/p1214.html

Long-term PPI Therapy and the Risk of Hip Fracture - AFP Journal Club - American Family...

Feb 1, 2008 - Does the long-term use of PPIs increase the risk of hip fracture? The physician must balance the risks and benefits of PPIs, especially in certain patients.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2008/0201/p277.html

Choosing First-Line Therapy for Management of Type 2 Diabetes - AFP Journal Club - ...

Jan 1, 2008 - Which controls type 2 diabetes best at five years: rosiglitazone, metformin, or glyburide? Metformin should be the first-line drug for managing type 2 diabetes. Insulin and sulfonylureas should be second line, and glitazones should be reserved for third line.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2008/0101/p16.html

NSAIDs vs. Acetaminophen for the Treatment of Ankle Sprains - AFP Journal Club - ...

Dec 1, 2007 - Are NSAIDs better than acetaminophen for ankle sprains? Extended-release acetaminophen provides equivalent analgesia and return to activity as an NSAID in patients with mild to moderate ankle sprains. All NSAIDs have equivalent analgesic effect.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2007/1201/p1605.html

Fluticasone or Salmeterol Alone vs. Combination Therapy for COPD - AFP Journal Club - ...

Mar 1, 2008 - Is fluticasone plus salmeterol better than fluticasone or salmeterol alone for treating patients with COPD? Anticholinergics are the bronchodilators of choice. Neither fluticasone nor the combination of fluticasone and salmeterol were no better than placebo at preventing mortality.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2008/0301/p586.html

Inhaled Steroid Use and Asthma Control in Patients with Mild Persistent Asthma - AFP ...

Jul 1, 2008 - Can patients with mild persistent asthma safely decrease or eliminate inhaled steroids? The results of these studies may not be generalizable to the average primary care patient. Patients should be appropriately classified and treated using 2007 National Asthma Education and Prevention ...

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2008/0701/p21.html

The Role of Chest CT in Diagnosing Pulmonary Embolism - AFP Journal Club - American ...

Sep 1, 2008 - How good is chest CT at identifying pulmonary embolism? It might have higher false-positive and false-negative rates than previously thought.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2008/0901/p554.html

Treatment of Acute Ischemic Stroke with t-PA - AFP Journal Club - American Family ...

Apr 1, 2008 - Does the widespread use of the thrombolytic tissue plasminogen activator (t-PA) more beneficial or harmful in patients with acute stroke? The benefits must be balanced against the harms. Informed consent is necessary when making the decision.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2008/0401/p901.html

Cancer Risks Associated with CT Scanning - AFP Journal Club - American Family Physician

Jan 15, 2010 - ...ROBERT DACHS, MD, FAAFP, Ellis Hospital Family Medicine Residency Program, Schenectady, New York MARK A. GRABER, MD, FACEP, University of Iowa Carver College of Medicine, Iowa City, Iowa ANDREA DARBY-STEWART, MD, Scottsdale Healthcare, Scottsdale, Arizona Am Fam Physician. 2010 Jan...

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2010/0115/p111.html

Acyclovir or Steroids as Pharmacologic Treatment of Bell Palsy - AFP Journal Club - ...

Mar 15, 2009 - Does acyclovir or steroids speed recovery in adults with Bell palsy? This study suggests that it is reasonable to start prednisolone in some cases, but physicians should not forget about practical considerations, such as lubricant eye drops, pain management, and chewing instruction. ...

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2009/0315/p435.html

Honey as a Treatment for Cough in Children - AFP Journal Club - American Family Physician

Jul 15, 2009 - Is honey an effective treatment for cough in children? Although this study failed to provide convincing evidence of effectiveness, honey may be a safe alternative to soothe cough in children older than one year.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2009/0715/p120.html

Is Unfractionated Heparin Equivalent to Low-Molecular-Weight Heparin for Venous ...

Jun 1, 2008 - Is weight-based unfractionated heparin as good as weight-based low-molecular-weight heparin for outpatient treatment of venous thromboembolism? Even though this study was underpowered to prove equivalence, treatment with subcutaneous unfractionated heparin is a viable option.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2008/0601/p1492.html

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