Family Medicine
Choosing Wisely Canada-Top Five List in Hepatology
23 May, 2019 | 07:44h | UTCSee complete lists of low-value practices: Choosing Wisely U.S. / Choosing Wisely UK / Choosing Wisely Australia AND Choosing Wisely Canada
1 – Don’t order serum ammonia to diagnose or manage hepatic encephalopathy (HE).
2 – Don’t routinely transfuse fresh frozen plasma, platelets or give Vitamin K to reverse abnormal tests of coagulation in patients with cirrhosis prior to abdominal paracentesis, endoscopic variceal band ligation, or any other minor invasive procedures.
3 – Don’t order HFE genotyping based on serum ferritin values alone to diagnose hereditary hemochromatosis.
4 – Don’t perform computed tomography (CT) or magnetic resonance imaging (MRI) routinely to monitor benign focal liver lesions (ex. focal nodal hyperplasia, hemangioma).
5 – Don’t repeat hepatitis C viral load testing in an individual who has established chronic infection, outside of antiviral treatment.
(Under a Creative Commons license)
Systematic Review: Mucolytic Agents for Chronic Bronchitis or Chronic Obstructive Pulmonary Disease
22 May, 2019 | 06:16h | UTCMucolytic agents versus placebo for chronic bronchitis or chronic obstructive pulmonary disease – Cochrane Library (free)
Summary: Mucolytic agents for chronic bronchitis or chronic obstructive pulmonary disease – Cochrane Library (free)
Update in Surveillance Recommendations in Individuals with Conventional Adenomas
22 May, 2019 | 06:02h | UTC
Large Study Shows Most Infant Deaths in Sitting Devices Occur Outside of Travel
22 May, 2019 | 05:51h | UTCInfant Deaths in Sitting Devices – Pediatrics (link to abstract – $ for full-text)
News Release: Large study sheds light infant deaths in sitting devices – American Academy of Pediatrics (free)
Commentaries: Car seat danger: Babies shouldn’t sleep in car seats when not traveling – Today (free) AND Sleep-Related Car Seat Deaths Occur Most Often Outside of Travel – NEJM Journal Watch (free)
A Review of Novel Antidepressants: A Guide for Clinicians
21 May, 2019 | 14:56h | UTCA Review of Novel Antidepressants: A Guide for Clinicians – Cureus (free)
#ATS2019 – Controlled Trial of Budesonide–Formoterol as Needed for Mild Asthma
21 May, 2019 | 06:16h | UTCControlled Trial of Budesonide–Formoterol as Needed for Mild Asthma – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary: Treatment Changes for Mild Asthma? – NEJM Journal Watch (free)
Just Presented at the 2019 Meeting of the American Thoracic Society.
#ATS2019 – Randomized Trial: Patients with Mild Asma and Low Sputum Eosinophil Levels Do Not Benefit from Inhaled Corticosteroids
21 May, 2019 | 06:15h | UTCMometasone or Tiotropium in Mild Asthma with a Low Sputum Eosinophil Level – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary: Large portion of patients with mild persistent asthma and low sputum eosinophils respond equally well to inhaled corticosteroids as placebo – NIH News Releases (free)
Just Presented at the 2019 Meeting of the American Thoracic Society.
Viewpoint – “Millions Take Gabapentin for Pain. But There’s Scant Evidence It Works.”
21 May, 2019 | 06:04h | UTCMillions Take Gabapentin for Pain. But There’s Scant Evidence It Works. – The New York Times (10 articles per month are free)
Related: Meta-Analysis: Anticonvulsants in the Treatment of Low Back Pain and Lumbar Radicular Pain (free) AND Benefits and safety of gabapentinoids in chronic low back pain (free) AND Less is More: A Clinical Overview of Off-label Use of Gabapentinoid Drugs (link to abstract)
Blood Pressure and the New ACC/AHA Hypertension Guidelines
20 May, 2019 | 17:09h | UTCBlood Pressure and the New ACC/AHA Hypertension Guidelines – Trends in Cardiovascular Medicine (free)
Original Guideline: 2017 Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines (free)
Related: 2018 ESC/ESH Guidelines for the management of arterial hypertension – European Heart Journal (free) AND What’s New in the ESC 2018 Guidelines for Arterial hypertension: The Ten Most Important Messages (free) AND AAFP Decides to Not Endorse AHA/ACC Hypertension Guideline – American Academy of Family Physicians (free) AND Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Synopsis of the 2017 American College of Cardiology/American Heart Association Hypertension Guideline – Annals of Internal Medicine (free) AND Hypertension Canada’s 2018 Guidelines for Diagnosis, Risk Assessment, Prevention, and Treatment of Hypertension in Adults and Children – Canadian Journal of Cardiology (free)
Observational Study Suggests Fruit Juices May Be as Unhealthy as Sugar-Sweetened Beverages
19 May, 2019 | 21:36h | UTCCommentaries: Are Fruit Juices Just as Unhealthy as Sugar-Sweetened Beverages? – JAMA Network Open (free) AND Fruit juice may increase death risk as much as sugary drinks – UPI (free) AND Expert reaction to study looking at sugary drinks, fruit juice and risk of premature death in US adults – Science Media Centre (free)
Author Interview: Association of Sugary Beverage Consumption With Mortality Risk in US Adults; Trends in Suicide Among US Youth Aged 10 to 19 Years, 1975 to 2016 (free audio)
Two Studies Point to Increase in Colorectal Cancer Incidence in Young Adults
19 May, 2019 | 13:27h | UTCChanges in colorectal cancer incidence in seven high-income countries: a population-based study – The Lancet Gastroenterology & Hepatology (link to abstract – $ for full-text)
Related Research: Increasing incidence of colorectal cancer in young adults in Europe over the last 25 years – Gut (link to abstract – $ for full-text)
Commentaries: Bowel cancer rates rising ‘among young adults’ – BBC (free) AND Expert reaction to two studies on the rise of bowel cancer among young adults – Science Media Centre (free) AND Colorectal cancer is killing more 20- to 30-year-olds. We have some clues about why. – VOX (free)
AHA/ACC Statement: Home-Based Cardiac Rehabilitation
17 May, 2019 | 06:59h | UTCSummaries: Scientific Statement on Home-Based Cardiac Rehabilitation – American College of Cardiology (free) AND Top Things to Know:
Home-Based Cardiac Rehabilitation – American Heart Association (free)
News Releases: New Scientific Statement Explores Home-Based Cardiac Rehab Strategy – American College of Cardiology (free) AND Home-based cardiac rehabilitation is an option to overcome barriers of traditional cardiac rehabilitation – American Heart Association (free)
Commentaries: Home-based heart rehab may help patients who can’t get to clinics – Reuters (free) AND Home-Based Cardiac Rehab a “Reasonable Option” – NEJM Journal Watch (free)
Randomized Trial: Low-Fat Diet May Reduce the Risk of Death From Breast Cancer in Postmenopausal Women
17 May, 2019 | 06:57h | UTCSee also: Healthy diet cuts risk of dying from breast cancer in older women – Reuters (free) AND Less fat, more fruit may cut risk of dying of breast cancer – Associated Press (free) AND Balanced, Low-Fat Diet Reduces Risk of Death From Breast Cancer in Postmenopausal Women – ASCO News Releases (free)
Study: Five-Year Outcomes of Gastric Bypass in Adolescents as Compared with Adults
17 May, 2019 | 06:52h | UTCFive-Year Outcomes of Gastric Bypass in Adolescents as Compared with Adults – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary: Early weight-loss surgery may improve type 2 diabetes, blood pressure outcomes – NIH/National Institute of Diabetes and Digestive and Kidney Diseases (free) AND Obesity surgery benefits may be bigger for teens than adults – Associated Press (free)
Systematic Review: Normal Body Temperature
17 May, 2019 | 06:41h | UTCNormal Body Temperature: A Systematic Review – Open Forum Infectious Diseases (free)
See also: Interest “Tweetorial” about the definition of a fever (thread)
Related Commentary on Twitter
Two superb reviews of "normal" body temperature.
1) This tweetorial.
2) This review paper just published in OFID.
Normal Body Temperature: A Systematic Review https://t.co/gVwMx7UbYc https://t.co/m2fl74xH2K— Paul Sax (@PaulSaxMD) May 15, 2019
Perspective: How Much Alcohol Can You Drink Safely?
17 May, 2019 | 06:49h | UTCHow Much Alcohol Can You Drink Safely? – The New York Times Magazine (10 articles per month are free)
Related Articles: Alcohol Use and Burden for 195 Countries and Territories (free) AND Meta-analysis: Risk Thresholds for Alcohol Consumption (free )
Study: Incident Exposure to Benzodiazepines in Early Pregnancy and Risk of Spontaneous Abortion
17 May, 2019 | 06:39h | UTCAssociation Between Incident Exposure to Benzodiazepines in Early Pregnancy and Risk of Spontaneous Abortion – JAMA Psychiatry (free for a limited period)
Commentaries: Benzodiazepine Use in Early Pregnancy Increases Risk of Miscarriage, Study Suggests – Psychiatry News Alert (free) AND Assess benzodiazepines’ risk-benefit before use in early pregnancy – OnMedica (free) AND Benzodiazepine Use in Early Pregnancy Linked to Spontaneous Abortion – MPR (free)
Pilot Study Suggests Targeting Insulin Resistance May Improve Fibromyalgia
16 May, 2019 | 06:09h | UTCIs insulin resistance the cause of fibromyalgia? A preliminary report – PLOS One (free)
Commentary: Fibromyalgia: Is insulin resistance ‘the missing link?’ – Medical News Today (free)
BMJ Guideline: Treatment of Subclinical Hypothyroidism
16 May, 2019 | 05:26h | UTCThyroid hormones treatment for subclinical hypothyroidism: a clinical practice guideline – The BMJ (free)
Commentaries: Experts advise against hormone treatment in adults with mild thyroid problems – The BMJ (free) AND Experts: Don’t Treat Subclinical Hypothyroidism – NEJM Journal Watch (free)
Related: Meta-Analysis: Treating Subclinical Hypothyroidism is Not Associated with Quality of Life and Thyroid-Related Symptoms (link to abstract and commentaries) AND Thyroid Hormone Therapy for Older Adults with Subclinical Hypothyroidism (free study and commentary)
Related Commentary on Twitter
Our new #RapidRecs @bmj_latest : #Thyroid #hormones (levothyroxine) should not be routinely offered to adults with mildly underactive thyroid gland (subclinical hypothyroidism) https://t.co/KZRz3R3a5C @MiekeVer@TrudyBekkering @theMAGICapp @Hopitaux_unige @will_s_t @HEI_mcmaster pic.twitter.com/6xQ078Lf4r
— Thomas Agoritsas, MD PhD (@ThomasAgoritsas) May 14, 2019
Cohort Study: Chronic Use of Tramadol After Acute Pain Episode
16 May, 2019 | 05:19h | UTCChronic use of tramadol after acute pain episode: cohort study – The BMJ (free)
Commentaries: Risk of Prolonged Use With Tramadol vs Other Short Acting Opioids Examined – MPR (free) AND ‘There really is no safe opioid’: Study finds tramadol isn’t a less addictive painkiller – CBC (free)
Related Commentary on Twitter
Tramadol use is associated with a higher risk of prolonged opioid use in patients with an acute episode of pain compared with other short acting opioids, finds new research @mollyjeffery https://t.co/PK0SYpINT7
— The BMJ (@bmj_latest) May 14, 2019
Otitis Externa: Investigation and Evidence-Based Treatment
16 May, 2019 | 05:13h | UTCOtitis Externa: Investigation and Evidence-Based Treatment – Deutsches Ärzteblatt International (free)
Alex Nowbar’s Journal Reviews—14 May 2019
15 May, 2019 | 06:37h | UTCAlex Nowbar’s journal reviews, 14 May 2019 – The BMJ Opinion (free)
Alex Nowbar reviews the latest research from the top medical journals.
Meta-Analysis: Potentially Inappropriate Prescribing Among Older Persons
15 May, 2019 | 06:39h | UTCNews Release: Inappropriate prescribing can lead to adverse outcomes – American Academy of Family Physicians (free)
Perspective: The Dangers of Ignoring the Beers Criteria—The Prescribing Cascade
15 May, 2019 | 06:43h | UTCThe Dangers of Ignoring the Beers Criteria—The Prescribing Cascade – JAMA Internal Medicine (free for a limited period)
Original Article: AGS 2019 Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults (link to abstract – $ for full-text)
Study: Estimated Quality of Life and Economic Outcomes Associated With 12 Cervical Cancer Screening Strategies
14 May, 2019 | 05:58h | UTCEstimated Quality of Life and Economic Outcomes Associated With 12 Cervical Cancer Screening Strategies: A Cost-effectiveness Analysis – JAMA Internal Medicine (free for a limited period)
Invited Commentary: Screening Options for Preventing Cervical Cancer (free for a limited period)
Author Interview: Estimated Quality of Life and Economic Outcomes Associated With Cervical Cancer Screening (free audio)
“Cytologic testing every 3 years and low-cost high-risk human papillomavirus testing every 5 years both may be considered reasonable cervical cancer screening options.”
Related Commentary on Twitter
Cytology every 3 years and low-cost #hrHPV testing every 5 years are both reasonable cervical-cancer screening options for women ages 30-65. https://t.co/yRCzmKGxP9
— JAMA Internal Medicine (@JAMAInternalMed) May 13, 2019