Priority Updates from the Research Literature (PURLs) distill the literature to those few articles that are relevant, practice-changing, and able to be implemented immediately. They generate new evidence-based recommendations for practice for family physicians and other primary care clinicians. PURLs are published exclusively in the Journal of Family Practice.

Recent Submissions

  • Sterile or non-sterile gloves for minor skin excisions? 

    Rietz, Ashley; Barzin, Amir; Jones, Kohar; Mounsey, Anne (Family Physicians Inquiries Network, 2015-11)
    Sterile or non-sterile gloves for minor skin excisions? Non-sterile gloves are just as effective as sterile gloves in preventing surgical site infection after minor skin surgeries. PRACTICE CHANGER: Consider using non-sterile ...
  • This adjunct medication can speed CAP recovery 

    Kirley, Katherine; Jarrett, Jennie Borders; Sauereisen, Sandra (Family Physicians Inquiries Network, 2015-10)
    This adjunct medication can speed CAP recovery: Adding prednisone to the antibiotic regimen can help patients hospitalized with community-acquired pneumonia to stabilize more quickly and leave the hospital sooner. PRACTICE ...
  • It’s time to reconsider early-morning testosterone tests 

    Long, Natalie; Nguyen, Liz; Stevermer, James (Family Physicians Inquiries Network, 2015-07)
    Guidelines recommend collecting an early-morning sample to compensate for the natural diurnal variation in testosterone levels. But for men 45 and older, this is unnecessary. Practice changer: Early-morning testosterone ...
  • Consider these medications to help patients stay sober 

    Hendry, Sydney; Mounsey, Anne (Family Physicians Inquiries Network, 2015-04)
    Naltrexone can help prevent relapse in recently detoxified patients with alcohol use disorder. The evidence for acamprosate is not quite as strong. Practice changer: Consider prescribing oral naltrexone (50 mg/d) for ...
  • Another good reason to recommend low-dose aspirin 

    Oyola, Sonia; Kirley, Katherine (Family Physicians Inquiries Network, 2015-05)
    Evidence shows that daily low-dose aspirin during pregnancy can safely lower the risk of preeclampsia and other adverse outcomes. Practice changer: Prescribe low-dose aspirin (eg, 81 mg/d) to pregnant women who are at ...
  • A new adjunctive Tx option for venous stasis ulcers 

    Crenshaw, Benjamin H.; Roberson, Kortnee Y.; Stevermer, James J. (Family Physicians Inquiries Network, 2015-03)
    A new adjunctive Tx option for venous stasis ulcers. Practice changer: Consider adding simvastatin 40 mg/d to standard wound care and compression for patients with venous stasis ulcers.
  • Skip this step when checking lipid levels 

    Wootten, Michael; Stulberg, Debra B.; Prasad, Shailendra; Rowland, Kate (Family Physicians Inquiries Network, 2015-02)
    Skip this step when checking lipid levels. Practice changer: requiring your patients to fast before undergoing lipid testing. Nonfasting total cholesterol (TC), high-density lipoprotein cholesterol (HDL), and low-density ...
  • Helmets for positional skull deformities: A good idea, or not? 

    Rowland, Kate; Das, Nil (Family Physicians Inquiries Network, 2015-01)
    Helmets for positional skull deformities: A good idea, or not? Probably not. Helmets appear to be no more effective than waiting for natural skull growth to correct the shape of an infant’s head. Practice Changer: Do not ...
  • Prescribing statins for patients with ACS? No need to wait 

    Gov-Ari, Hanna K.; Stevermer, James J. (Family Physicians Inquiries Network, 2014-12)
    PRACTICE CHANGER: Prescribe a high-dose statin before any patient with acute coronary syndrome (ACS) undergoes percutaneous coronary intervention (PCI); it may be reasonable to extend this to patients being evaluated for ACS.1
  • Probiotics for colic? A PURL update 

    Stulberg, Debra B. (Family Physicians Inquiries Network, 2014-10)
    In “Colicky baby? Here’s a surprising remedy” (J Fam Pract. 2011;60:34-36), we summarized a 2010 doubleblind randomized controlled trial (RC T) that found the probiotic Lactobacillus reuteri DSM 17938 reduced daily crying ...
  • An antiemetic for irritable bowel syndrome? 

    Levy, Robert; Corbo, Jason M.; Prasad, Shailendra (Family Physicians Inquiries Network, 2014-10)
    An antiemetic for irritable bowel syndrome? A drug used for cancer patients may provide some relief to patients with IBS. Practice changer: Consider prescribing ondansetron up to 24 mg/d for patients who have irritable ...
  • Surgery for persistent knee pain 

    Brown, Mallory McClester; Mounsey, Anne (Family Physicians Inquiries Network, 2014-09)
    Surgery for persistent knee pain? Not so fast. Practice changer: Do not refer patients with a degenerative medial meniscus tear for arthroscopic partial meniscectomy because outcomes are no better than those of conservative ...
  • Suctioning neonates at birth: time to change our approach 

    Neumann, Iliana; Mounsey, Anne; Das, Niladri (Family Physicians Inquiries Network, 2014-08)
    There’s a better way to clear secretions from a neonate’s mouth and nose, and it’s less likely to cause adverse effects. Practice Changer: Stop suctioning neonates at birth. There is no benefit to this practice, and it ...
  • Skip the compression stockings following DVT 

    Bergeson, Keri; Prasad, Shailendra; Benson, Janice L. (Family Physicians Inquiries Network, 2014-07)
    Although commonly used, compression stockings do not effectively prevent post-thrombotic syndrome. Practice changer: Do not recommend elastic compression stockings (ECS) to decrease the incidence of post-thrombotic syndrome ...
  • Why you shouldn’t start beta-blockers before surgery 

    Mounsey, Anne; Roque, Jodi M.; Egan, Mari E. (Family Physicians Inquiries Network, 2014-06)
    A new meta-analysis finds that initiating beta-blockers before surgery increases patients’ risk of death. Practice changer: Do not routinely initiate beta-blockers in patients undergoing intermediate- or high-risk noncardiac ...
  • Think twice about nebulizers for asthma attacks 

    Kirley, Kate; Nguyen, Liz (Family Physicians Inquiries Network, 2014-06)
    MDIs with spacers are as effective as nebulizers for delivering beta-agonists and less likely to cause adverse effects. Practice changer: Stop ordering nebulizers to deliver beta-agonists to patients over age 2 with mild ...
  • Finally, a way to relieve cancer-related fatigue 

    Thomas, Gayle B.; Asher, Gary N.; Mounsey, Anne (Family Physicians Inquiries Network, 2014-05)
    A 4-week course of American ginseng, taken while patients are undergoing radiation or chemotherapy, can reduce cancer-related fatigue. PRACTICE CHANGER: Recommend American ginseng 1000 mg twice daily for 4 weeks to ...
  • A simple way to reduce catheter-associated UTIs 

    Pereira, Susan; Nguyen, Liz; Stevermer, James J. (Family Physicians Inquiries Network, 2014-05)
    The administration of a prophylactic antibiotic when a surgical patient’s urinary catheter is removed can cut the rate of urinary tract infections in half. PRACTICE CHANGER: Ensure that antibiotics are administered to ...
  • Prolotherapy: A nontraditional approach to knee osteoarthritis 

    Slattengren, Andrew H.; Christensen, Trent; Prasad, Shailendra; Jones, Kohar (Family Physicians Inquiries Network, 2014-04)
    Recommend prolotherapy for patients with knee osteoarthritis (OA) that does not respond to conventional therapies.
  • Should you consider antibiotics for exacerbations of mild COPD? 

    Tanner, Tanner; Prasad, Shailendra (Family Physicians Inquiries Network, 2014-04)
    Consider antibiotics for patients with exacerbations of mild to moderate chronic obstructive pulmonary disease (COPD).

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