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Monotherapy for nonvalvular A-fib with stable CAD?
(Family Physicians Inquiries Network, 2021)
A meta-analysis found oral anticoagulant (OAC) monotherapy provided efficacy comparable to OAC plus single antiplatelet therapy--with lower bleeding risk.
Skip that repeat DXA scan in these postmenopausal women
(Family Physicians Inquiries Network, 2021)
Skip that repeat DXA scan in these postmenopausal women. Repeat bone density measurement offers no advantage in predicting fracture risk in postmenopausal women who do not have osteoporosis. PRACTICE CHANGER: Do not routinely ...
Validated scoring system identifies low-risk syncope patients
(Family Physicians Inquiries Network, 2021)
This study validated the Canadian Syncope Risk Score for predicting 30-day serious outcomes in patients presenting to the ED within 24 hours of syncope.
Prescribe an SGLT2 inhibitor for heart failure in the absence of diabetes?
(Family Physicians Inquiries Network, 2021)
Prescribe an SGLT2 inhibitor for heart failure in the absence of diabetes? An RCT demonstrates that dapagliflozin produces better cardiovascular outcomes than placebo for heart failure patients with and without diabetes. ...
This is not the time to modify a HTN regimen
(Family Physicians Inquiries Network, 2021)
This is not the time to modify a HTN regimen. Intensifying hypertension regimens at discharge increases risk in older patients. PRACTICE CHANGER: Avoid intensifying antihypertensive medication regimens at hospital discharge ...
Effect of Chronic Illnesses on Length of Stay and Mortality of Community Acquired Pneumonia in a Community Hospital
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2020-01)
The aim of this study was to determine the effect of demographics, substance abuse, and chronic illnesses on length of hospitalization and mortality of pneumonia. 866 patients admitted to a community hospital with diagnosis ...
Endoscopic Ultrasound for the Treatment of Gastric Variceal Bleeding in a Patient with Portal Cavernoma
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2020-07)
"A 30-year-old lady was admitted with two weeks of fever and right upper quadrant pain. She had a background of non-malignant, non-cirrhotic portal vein thrombosis (PVT) with cavernoma formation. There was no detected ...
Oral versus Intravenous Antimicrobials for Serious Infections
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2020-07)
"There is a common belief among physicians and patients, that “intravenous (IV) antibiotics are better than oral antibiotics, they are stronger, they work faster”. However, for many infectious conditions, including serious ...
A re-challenging case
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2020-01)
"Immune Checkpoint Inhibitors (ICI) are associated with multiple cardiotoxic effects. Balancing adverse effects with anti-tumor response poses a challenge to treating advanced cancers. The safety of re-starting ICI therapy ...
Consider this Rx for patients with high triglycerides?
(Family Physicians Inquiries Network, 2020)
A daily dose of this prescription fish oil may be worth a trial in light of the cardiovascular benefits it affords statin-treated patients with high triglycerides. PRACTICE CHANGER: Consider icosapent ethyl, 2 g twice ...
USPSTF expands options for cervical cancer screening
(Family Physicians Inquiries Network, 2020)
Women ages 30-65 years now have a third cervical cancer screening option. PRACTICE CHANGER: Offer women ages 30-65 years the option of being screened for cervical cancer using a high-risk human papillomavirus assay every ...
Aspirin, yes, for at-risk elderly : but what about the healthy elderly?
(Family Physicians Inquiries Network, 2020)
Aspirin, yes, for at-risk elderly -- but what about the healthy elderly? This study paints a decidedly different picture as to what role -- if any -- aspirin can play in the primary prevention of CVD for older adults. ...
Do-it-yourself cervical cancer screening?
(Family Physicians Inquiries Network, 2020)
Enlisting patients to self-collect specimens for human papillomavirus testing is an effective way to detect cervical precancer in those who might not otherwise undergo cervical cancer screening. PRACTICE CHANGER: Have ...
Can drinking more water prevent urinary tract infections?
(Family Physicians Inquiries Network, 2020)
Can drinking more water prevent urinary tract infections? A high-quality randomized controlled trial says 'Yes'. PRACTICE CHANGER: Advise premenopausal women with recurrent urinary tract infections (UTIs) and low-volume ...
Q: Can family physicians accurately screen for AAA with point-of-care ultrasound?
(Family Physicians Inquiries Network, 7/8/2021)
Evidence-based answer: LIKELY YES. Point-of-care ultrasound (POCUS) screening for abdominal aortic aneurysm (AAA) by nonradiologist physicians is 98% sensitive and 99% specific, compared with imaging performed by radiologists ...
Which medications work best for menorrhagia?
(Family Physicians Inquiries Network, 2020)
Q: Which medications work best for menorrhagia? Evidence-based answer: Four medications have been shown to reduce menstrual blood loss (MBL) significantly in placebo-controlled randomized controlled trials (RCTs): the ...
Ruling out PE in pregnancy
(Family Physicians Inquiries Network, 2020)
Can clinical probability and a high-sensitivity D-dimer test reliably and safely rule out pulmonary embolism during pregnancy? PRACTICE CHANGER: Use a clinical probability score to identify patients at low or intermediate ...
Does early introduction of peanuts to an infant's diet reduce the risk for peanut allergy?
(Family Physicians Inquiries Network, 2020)
Q: Does early introduction of peanuts to an infant's diet reduce the risk for peanut allergy? Evidence-based answer: Probably not, unless the child has severe eczema or egg allergy. In a general pediatric population, ...
What is the best treatment for wrist ganglion cysts?
(Family Physicians Inquiries Network, 2020)
Q: What is the best treatment for wrist ganglion cysts? Evidence-based answer: Open surgical excision of wrist ganglion cysts is associated with a lower recurrence rate than aspiration with or without corticosteroid injection ...
A better approach to preventing active TB?
(Family Physicians Inquiries Network, 2020)
A better approach to preventing active TB? Nine months of isoniazid prevents active TB in those with latent disease. But is there a shorter, less toxic option? PRACTICE CHANGER: Use 4 months of rifampin instead of 9 months ...