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Association of Antidepressant Use With Drug-Related Extrapyramidal Symptoms: A Pharmacoepidemiological Study – Journal of Clinical Psychopharmacology (link to abstract – $ for full-text)

Commentaries: Incidence of Extrapyramidal Symptoms Higher With Certain Antidepressants – MPR (free) AND Antidepressants tied to Parkinson’s-like symptoms – Univadis (free registration required)

“Observational study: Incidence of EPSs with antidepressants. RRs: duloxetine, 5.68; mirtazapine, 3.78; citalopram, 3.47; escitalopram, 3.23; paroxetine, 3.07; sertraline, 2.57; venlafaxine, 2.37; bupropion, 2.31; and fluoxetine, 2.03 (all significant)” (via @psychopharmacol see Tweet)

 


Prevalence and outcomes of incidental imaging findings: umbrella review – The BMJ (free)

Related: Giles Maskell: Incidental anarchy – The BMJ Opinion (free)

“Incidentalomas. If you order imaging studies, you know they are a problem. This meta-analysis quantifies incidentaloma prevalence for specific types of imaging. For MRI of the brain, the prevalence was 22% (95%CI 14 to 31) (via @RasoiniR and @eloder, see Tweet)

 


Prognostic Implications of Single-Sample Confirmatory Testing for Undiagnosed Diabetes: A Prospective Cohort Study – Annals of Internal Medicine (link to abstract – $ for full-text)

Commentaries: Diagnosing Diabetes From a Single Blood Sample – Johns Hopkins Bloomberg School of Public Health, via NewsWise (free) AND One Blood Test Might Be Enough to Diagnosis – HealthDay (free) AND Diabetes Dx Predicted Accurately with Single Blood Sample – MedPage Today (free registration required)

“The standard practice of repeat blood tests may not always be necessary, a new study suggests” (from Johns Hopkins Bloomberg School of Public Health)

 


Helping patients choose wisely – The BMJ (free)

Related: The Choosing Wisely initiative was launched 5 years ago, and now has over 490 recommendations from 18 countries (free)

See complete lists from: Choosing Wisely U.S., Choosing Wisely UKChoosing Wisely Australia AND Choosing Wisely Canada

“One of the main barriers to tackling the problem of overuse is that doctors are concerned patients will find it difficult to accept fewer interventions. However, informed patients often opt for less intervention, not more.” (via @bmj_latest see Tweet)

 


Richard Lehman’s journal review, 18 June 2018 – The BMJ Opinion (free)

Richard Lehman reviews the latest research in the top medical journals.

 


Richard Lehman’s journal review, 11 June 2018 – The BMJ Opinion (free)

Richard Lehman reviews the latest research in the top medical journals.

 


Stimulants for ADHD in children: Revisited – Therapeutics Initiative (via @AllenFrancesMD)

“There is convincing evidence that a proportion of boys and girls treated with stimulants in BC and around the world are simply the youngest in their class”

 


Richard Lehman’s journal review, 4 June 2018 – The BMJ Opinion (free)

Richard Lehman reviews the latest research in the top medical journals.

 


Richard Lehman’s journal review, 29 May 2018 – The BMJ Opinion (free)

Richard Lehman reviews the latest research in the top medical journals.

 


Incidental anarchy – The BMJ Opinion (free)

“Giles Maskell writes on over diagnosis and underdiagnosis, the complexities of incidental findings and urges clinicians to “Think before you scan because you can” (via @bmj_latest see Tweet)


Aspirin Effect on Adverse Pregnancy Outcomes Associated With Stage 1 Hypertension in a High-Risk Cohort – Hypertension (link to abstract – $ for full-text)

Commentary: Low-dose aspirin could help pregnant women with high blood pressure avoid a dangerous condition – AHA News (free)

Related Study: Aspirin versus Placebo in Pregnancies at High Risk for Preterm Preeclampsia (free article and commentaries)

“These findings emphasize the importance of recognition of stage 1 hypertension as an additive risk factor in women at high risk for preeclampsia and the benefit of aspirin”.

 


A1C Targets Should Be Personalized to Maximize Benefits While Limiting Risks – Diabetes Care (free) (via @Abraham_RMI)

Related guideline: Hemoglobin A1c Targets for Glycemic Control With Pharmacologic Therapy for Nonpregnant Adults With Type 2 Diabetes Mellitus: A Guidance Statement Update From the American College of Physicians (free)

“Clinicians should aim to achieve an HbA1c level between 7% and 8% in most patients with type 2 diabetes” (from ACP Guideline, prompting the Editorial)

 


Richard Lehman’s weekly journal review, 21 May 2018 – The BMJ Opinion (free)

Richard Lehman reviews the latest research in the top medical journals.

 


Aldosterone Antagonist Therapy and Mortality in Patients With ST-Segment Elevation Myocardial Infarction Without Heart Failure: A Systematic Review and Meta-analysis – JAMA Internal Medicine (free for a limited period)

Invited Commentary: Mineralocorticoid Receptor Antagonists in ST-Segment Elevation Myocardial Infarction – JAMA Internal Medicine (free for a limited period)

Aldosterone antagonists are beneficial for patients with STEMI and reduced ejection fraction. This meta-analysis suggests that patients with STEMI and LVEF greater than 40% or without heart failure also have improved outcomes with aldosterone antagonists.

 


Dose Increase Versus Unchanged Continuation of Antidepressants After Initial Antidepressant Treatment Failure in Patients With Major Depressive Disorder: A Systematic Review and Meta-Analysis of Randomized, Double-Blind Trials – The Journal of Clinical Psychiatry (link to abstract – $ for full-text)

Commentary: Depression: boosting SSRIs doesn’t work – Univadis (free registration required)

“Meta-analysis: there is evidence from RCTs against increasing the dose of SSRIs (with the possible exception of citalopram) in adult patients with major depression and antidepressant treatment failure” (via @psychopharmacol see Tweet)

 


Richard Lehman’s journal review, 14 May 2018 – The BMJ Opinion (free)

Richard Lehman reviews the latest research in the top medical journals.

 


Clinical Pearl: Essential Tremor – NEJM Resident 360 (free)

 


Richard Lehman’s journal review, 8 May 2018 – The BMJ Opinion (free)

Richard Lehman reviews the latest research in the top medical journals.

 


Clinical Practice Guideline: Chronic Asthma – Toward Optimized Practice (free PDF)

See also: Summary (free PDF)

Related: see all TOP Clinical Practice Guidelines, a practical resource for Family Physicians at the point of care.

 


Richard Lehman’s journal review, 30 April 2018 – The BMJ Opinion (free)

Richard Lehman reviews the latest research in the top medical journals.

 


Lecture: How Less Health Care Can (Sometimes) Be Better For You (free Youtube video)

See also other CLUE Working Group Lecture Series (tweet with lecture links by @KariTikkinen)

“Editor-in-Chief of @JAMAInternalMed, professor Rita Redberg gave the 3rd CLUE Working Group lecture entitled “How Less Health Care Can (Sometimes) Be Better For You” at the Think Corner of the U of Helsinki” (via @KariTikkinen see Tweet)

 



Anticholinergic drugs and risk of dementia: case-control study – The BMJ (free)

Editorial: Anticholinergic drugs and dementia in older adults (free)

Commentaries: Expert reaction to study investigating the association between different types of anticholinergic drugs and risk of dementia – Science Media Centre (free) AND Anticholinergic drugs may be linked to increased risk of dementia – OnMedica (free)

“The effect of anticholinergic therapy is relatively small (odds ratio 1.1 – 1.2) and establishing an association does not prove a causal link. Nevertheless, the paper may act as a useful guide for future research and clinical practice”. (by Prof Les Iversen, in Science Media Centre)

 


Should we recommend e-cigarettes to help smokers quit? – The BMJ (free)

See also: related guidelines, reports and commentaries on e-cigarettes

“Experts debate: Should doctors recommend e-cigarettes to help smokers quit? Revelation in harm reduction or a way to keep people addicted and gateway to youth smoking?” (via @rich_hurley see Tweet)

 


USPSTF Draft Recommendation Statement: Intimate Partner Violence, Elder Abuse, and Abuse of Vulnerable Adults: Screening (free)

Commentaries: USPSTF urges abuse screening for reproductive-aged women – MedicalXpress (free) AND USPSTF Recommends Screening for Partner Violence in Reproductive-Aged Women – Clinical Advisor (free)

“The USPSTF recommends that clinicians screen for intimate partner violence (IPV) in women of reproductive age and provide or refer women who screen positive to ongoing support services.”

 


Case managers improve outcomes for people with dementia and their carers – NIHR Signal (free)

Original Article: The effectiveness of community-based coordinating interventions in dementia care: a meta-analysis and subgroup analysis of intervention components – BMC Health Services Research (free)

“The review suggests that nurses may be particularly well placed to act as case managers for people with dementia, perhaps because they have the skills to perform the broad range of tasks associated with the role.” (via @NIHR_DC see Tweet)

 


Richard Lehman’s journal review, 23 April 2018 – The BMJ Opinion (free)

Richard Lehman reviews the latest research in the top medical journals.

 


Antifibrinolytics for heavy menstrual bleeding – Cochrane Library (link to abstract and summary)

“Antifibrinolytics appear effective tor treating for heavy menstrual bleeding, without substantially increasing the rate of adverse events” (via @CochraneLibrary see Tweet)

 


Safety and efficacy of dual vs. triple antithrombotic therapy in patients with atrial fibrillation following percutaneous coronary intervention: a systematic review and meta-analysis of randomized clinical trials – European Heart Journal (free)

Compared with triple antithrombotic therapy, dual antithrombotic therapy shows a reduction in TIMI major or minor bleeding by 47% with comparable outcomes of major adverse cardiac events.

 


First-line drugs for hypertension – Cochrane Library (free)

Summary: Thiazides best first choice for hypertension – Cochrane Library (free)

“First-line low-dose thiazides reduced all morbidity and mortality outcomes in adult patients with moderate to severe primary hypertension. First-line ACE inhibitors and calcium channel blockers may be similarly effective, but the evidence was of lower quality”.

 


Association Between Baseline LDL-C Level and Total and Cardiovascular Mortality After LDL-C Lowering: A Systematic Review and Meta-analysis – JAMA (link to abstract – $ for full-text)

Commentaries: Patients With Highest LDL Levels Benefit Most From Lipid-Lowering Drugs – MedicalResearch.com (free) AND New Study Finds that Statins Prevent Cardiovascular Deaths – Science Based Medicine (free) AND Meta-Analysis: ‘Floor’ for Lipid-Lowering Mortality Benefits May Be Real – MedPage Today (free registration required)

“In meta-analyses of LDL-C lowering drug trials, we found that total and cardiovascular mortality were reduced only when the mean baseline LDL-C in the trial was >100 mg/dl” (from MedicalResearch.com)

 


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