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

  • Steroids during late preterm labor: better later than never 

    Lyon, Corey; Bello, Jennifer (Family Physicians Inquiries Network, 2017-02)
    Steroids during late preterm labor: Better later than never. Steroids—even when administered in the last leg of the late preterm period—still reduce the likelihood of respiratory complications in newborns. Practice changer: ...
  • Need an add-on to metformin? Consider this 

    Wyncott, David; Lyon, Corey; Mounsey, Anne (Family Physicians Inquiries Network, 2017-01)
    Need an add-on to metformin? Consider this. Sulfonylureas have been the preferred add-on therapy to metformin for T2DM, but a study finds that DPP-4s have lower risks of death, CV events, and hypoglycemia. Practice changer: ...
  • A more palatable alternative to oral rehydration therapy for kids 

    Reust, Carin; Stevermer, James J.; Jarrett, Jennie B. (Family Physicians Inquiries Network, 2016-12)
    A more palatable alternative to oral rehydration therapy for kids. Parents no longer need to struggle to get their kids to drink electrolyte solutions during episodes of mild gastroenteritis; apple juice works just as well. ...
  • Monitoring home BP readings just got easier 

    Jarrett, Jennie B; Hogan, Linda; Lyon, Corey (Family Physicians Inquiries Network, 2016-10)
    Monitoring home BP readings just got easier. This novel method of identifying patients with uncontrolled hypertension correlates well with ambulatory BP monitoring. Practice changer: Use this easy "3 out of 10 rule" to ...
  • Deliver or wait with late preterm membrane rupture? 

    Bergeson, Keri; Prasad, Shailendra (Family Physicians Inquiries Network, 2016-11)
    Deliver or wait with late preterm membrane rupture? While ACOG recommends delivery for all women with ruptured membranes after 34 weeks' gestation, a new study finds expectant management may be the way to go. Practice ...
  • Yeast infection in pregnancy? Think twice about fluconazole 

    Barzin, Amir; Mounsey, Anne (Family Physicians Inquiries Network, 2016-09)
    Yeast infection in pregnancy? Think twice about fluconazole. This study's findings regarding the risk of miscarriage may mean it's time to forego fluconazole in favor of topical azoles as first-line treatment. Practice ...
  • On-demand pill protocol protects against HIV 

    Justesen, Kathryn; Prasad, Shailendra (Family Physicians Inquiries Network, 2016-08)
    On-demand pill protocol protects against HIV: Finally, there's an effective prevention strategy -- other than condoms -- that can be used, as needed, by patients at high risk for HIV infection. Practice changer: Offer ...
  • More isn't better with acute low back pain treatment 

    Frazer, Kevin; Stevermer, James (Family Physicians Inquiries Network, 2016-06)
    More isn't better with acute low back pain treatment Adding cyclobenzaprine or oxycodone/acetaminophen to naproxen for the treatment of acute low back pain does nothing more than increase adverse effects. Practice changer: ...
  • Light therapy for nonseasonal major depressive disorder? 

    Eniola, Kehinde; Bacigalupo, Angela; Mounsey, Anne (Family Physicians Inquiries Network, 2016-07)
    Light therapy for nonseasonal major depressive disorder? While bright light therapy already has a place in the treatment of seasonal affective disorder, a recent trial spotlights its utility beyond the winter months. ...
  • Go low or say No to aggressive systolic BP goals? 

    Day, Margaret; Steverner, James J. (Family Physicians Inquiries Network, 2016-05)
    "Go low" or say "No" to aggressive systolic BP goals? The SPRINT trial demonstrated the benefits -- and risks -- of reaching a systolic target <120 mm Hg in non-diabetic patients at high risk for CV events. Here's who might ...
  • Resistant hypertension? Time to consider this fourth-line drug 

    Kaysin, Alexander; Mounsey, Anne (Family Physicians Inquiries Network, 2016-04)
    Resistant hypertension? Time to consider this fourth-line drug For most adults with resistant hypertension, spironolactone is superior to doxazosin and bisoprolol as an adjunct to triple therapy. Practice changer: When a ...
  • Kidney stones? It's time to rethink those meds 

    Slattengren, Andrew H.; Prasad, Shailendra; Jarrett, Jennie B. (Family Physicians Inquiries Network, 2016-02)
    Kidney stones? It's time to rethink those meds. Despite being recommended for ureteral stone expulsion, tamsulosin or nifedipine are no more effective than placebo. Practice changer: Do not prescribe tamsulosin or nifedipine ...
  • Aneuploidy screening: Newer noninvasive test gains traction 

    Nickolich, Sarah; Farahi, Narges; Jones, Kohar; Mounsey, Anne (Family Physicians Inquiries Network, 2016-01)
    Favorable results from the 2 studies reviewed here have prompted ACOG to recommend that cell-free DNA screening be discussed with all pregnant patients. Practice changer: Discuss cell-free DNA testing when offering fetal ...
  • Should you bypass anticoagulant bridging before and after surgery? 

    Jarrett, Jennie B; Schaffer, Ted; Rowland, Kate (Family Physicians Inquiries Network, 2015-12)
    Should you bypass anticoagulant "bridging" before and after surgery? Skipping perioperative use of LMWH in low- and moderate-risk patients on warfarin for atrial fibrillation doesn't increase their risk of stroke or bleeding. ...
  • 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 L. (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.

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