RSS 1.0Priority Updates to Research Literature (PURLs)
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.
Items in MOspace are protected by copyright, with all rights reserved, unless otherwise indicated.
Recent Submissions
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On-demand pill protocol protects against HIV
(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 patients ... -
More isn’t better with acute low back pain treatment
(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?
(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?
(Family Physicians Inquiries Network, 2016-05)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 benefit. Practice changer: Consider treating non-diabetic ... -
Resistant hypertension? Time to consider this fourth-line drug
(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
(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
(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?
(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?
(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
(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
(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
(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
(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
(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
(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?
(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
(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
(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?
(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
(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 ...