Family Medicine

Meta-analysis of cohort studies: in patients who experienced an ischemic stroke or transient ischemic attack while on aspirin monotherapy, the addition of or a switch to another antiplatelet agent, versus aspirin monotherapy, was associated with a 32 percent reduction in the risk of major adverse cardiovascular events (HR 0.68; 0.54–0.85) and 30 percent reduction in recurrent strokes (HR, 0.70; 0.54–0.92). Additional randomized trials would better clarify the best antiplatet regimen for these patients.

NICE Guideline: Parkinson’s disease in adults

21 Jul, 2017 | 17:52h | UTC

Parkinson’s disease in adults – National Institute for Health and Care Excellence (NICE) Guideline (free)

Effect of diet and physical activity based interventions in pregnancy on gestational weight gain and pregnancy outcomes

21 Jul, 2017 | 17:46h | UTC

Effect of diet and physical activity based interventions in pregnancy on gestational weight gain and pregnancy outcomes: meta-analysis of individual participant data from randomised trials – The BMJ (free)

Editorial: Diet and exercise in pregnancy (free)

Commentaries: Risk of caesarean reduced by healthy diet and physical activity during pregnancy, study finds – NewsMedical (free) AND C-Section Risk Reduction Linked to Healthy Lifestyle – MedPage Today (free)

Antidepressants during pregnancy and autism in offspring

21 Jul, 2017 | 17:49h | UTC

Antidepressants during pregnancy and autism in offspring: population based cohort study – The BMJ (free)

Editorial: Prenatal antidepressant use and risk of autism (free)

Commentaries: Antidepressants and pregnancy: study didn’t find they actually cause autism – The Conversation (free) AND Antidepressant use in pregnancy linked to autism in children – OnMedica (free) AND Study finds slight autism risk link to antidepressants in pregnancy – Reuters (free)

Dementia prevention, intervention, and care

21 Jul, 2017 | 17:40h | UTC

Report: Dementia prevention, intervention, and care – The Lancet (free registration required)

Commentaries: Experts: 1 in 3 cases of dementia preventable, nonmedical therapies ideal for dementia – University of Southern California, via EurekAlert (free) AND One Third of Dementia May Be Preventable With Lifestyle Change – Medscape (free registration required) AND Over a Third of Dementia Cases Tied to Modifiable Risk Factors – Physician’s First Watch (free) AND Living healthily, learning more could cut dementia cases by a third – Reuters (free) AND Lifestyle changes could prevent a third of dementia cases, report suggests – The Guardian (free)

The Aging Physician and the Medical Profession: A Review

21 Jul, 2017 | 00:25h | UTC

The Aging Physician and the Medical Profession: A Review – JAMA Sugery (free) (RT @EricTopol see Tweet)

Hepatology: Five Things Physicians and Patients Should Question

21 Jul, 2017 | 00:26h | UTC

New Choosing Wisely Canada List: Hepatology: Five Things Physicians and Patients Should Question (free) (RT @ChooseWiselyCA see Tweet)

See more on the Choosing Wisely initiative in our April 5 issue (see #6).

Community-associated methicillin-resistant Staphylococcus aureus infection

21 Jul, 2017 | 00:24h | UTC

Clinical Review: Community-associated methicillin-resistant Staphylococcus aureus infection: Literature review and clinical update – Canadian Family Physician (free)

Use of antibiotics during pregnancy and the risk of major congenital malformations

21 Jul, 2017 | 00:22h | UTC

Use of antibiotics during pregnancy and the risk of major congenital malformations: A population based cohort study – British Journal of Pharmacology (link to abstract – $ for full-text)

Commentary: New study finds link between certain antibiotics during pregnancy and risk for birth defects – News Medical (free)

In this large cohort clindamycin, doxycycline, quinolones, macrolides, and phenoxymethylpenicillin were associated with congenital malformations. Amoxicillin, cephalosporins, and nitrofurantoin were not associated with birth defects.

Healthful and Unhealthful Plant-Based Diets and the Risk of Coronary Heart Disease

20 Jul, 2017 | 00:13h | UTC

Healthful and Unhealthful Plant-Based Diets and the Risk of Coronary Heart Disease in U.S. Adults – Journal of The American College of Cardiology (link to abstract – $ for full-text)

Commentaries: Some Plant-Based Diets May Increase Heart Disease Risk –American College of Cardiology, Latest in Cardiology (free) AND Not All Vegetarian, Plant-Based Diets Equal for CHD Risk – Medscape (free registration required) AND Not all plant-based diets are created equal – American College of Cardiology, via ScienceDaily (free)

USPSTF Draft Recommendation Statement on Ovarian Cancer Screening

20 Jul, 2017 | 00:10h | UTC

Draft Recommendation Statement: Ovarian Cancer: Screening – U.S. Preventive Services Task Force (free)

Commentaries: USPSTF Again Recommends Against Screening General Population for Ovarian Cancer – Physician’s First Watch (free) AND USPSTF Stays Course on Ovarian Cancer Screening: No screening for asymptomatic women – MedPage Today (free registration required)

Oral antifungal medication for toenail onychomycosis

20 Jul, 2017 | 00:08h | UTC

Cochrane What is the best medication for a fungal infection of the toenail? – Cochrane Library (free)

Full review: Oral antifungal medication for toenail onychomycosis – Cochrane Library (link to abstract – $ for full-text)

Terbinafine probably leads to better cure rates than azoles, with the same risk of adverse events. Griseofulvin is no better and has more adverse effects than azoles.

Rhabdomyolysis & Exertional Heat Stroke

20 Jul, 2017 | 00:03h | UTC

As Workouts Intensify, a Harmful Side Effect Grows More Common – New York Times (10 articles per month are free)

Comprehensive geriatric assessment and optimization in vascular surgery

20 Jul, 2017 | 00:02h | UTC

Randomized clinical trial of comprehensive geriatric assessment and optimization in vascular surgery – British Journal of Surgery (link to abstract – $ for full-text)

Source: ACP Journal Club ($ resource to find articles of interest)

In this RCT, a comprehensive preoperative geriatric assessment and optimization before vascular surgery was associated with shorter length of hospital stay, lower incidence of complications, and patients were less likely to be discharged to a higher level of dependency.

Patient Outcomes in Dose Reduction or Discontinuation of Long-Term Opioid Therapy

20 Jul, 2017 | 00:04h | UTC

Patient Outcomes in Dose Reduction or Discontinuation of Long-Term Opioid Therapy: A Systematic Review – Annals of Internal Medicine (link to abstract – $ for full-text)

Commentaries: Tapering long-term opioid therapy may improve outcomes in chronic pain, review finds – ACP Internist (free) AND Opioid Reduction Therapy Offers Some Benefits to Patients with Chronic Pain – Physician’s First Watch (free) AND How tapering off opioids can help people with chronic pain – CNN (free)

“Opioid tapering:

– less pain: 8 of 8 studies

– Improved function: 5 of 5 studies

– Improved QOL: 3 of 3 studies” (RT @DavidJuurlink see Tweet)

Practical management of peripartum cardiomyopathy

Diabetic cardiomyopathy: where we are and where we are going

Maternal immunisation: collaborating with mother nature

Treatment Challenges of Group A Beta-hemolytic Streptococcal Pharyngo-Tonsillitis

Review: Optimizing diagnostic testing for venous thromboembolism

Surgical site infections after cesarean delivery: epidemiology, prevention and treatment

Antiplatelet Regimen for Patients With Breakthrough Strokes While on Aspirin