Family Medicine

Clinical Update: Metformin in 2019

23 Apr, 2019 | 01:50h | UTC

Metformin in 2019 – JAMA (free for a limited period)

 


Measles cases are up nearly 300% from last year. This is a global crisis – CNN (free)

WHO Statement: New measles surveillance data for 2019 – World Health Organization (free)

By Henrietta H Fore (executive director of UNICEF) and Tedros Adhanom Ghebreyesus (director general of the World Health Organization).

 


Proposal: Reforming disease definitions: a new primary care led, people-centred approach – BMJ Evidence Based Medicine (free)

Commentary: We need new rules for defining who is sick. Step 1: remove vested interests – The Conversation (free)

 

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Ann Robinson’s research reviews, 9 April 2019 – The BMJ Opinion (free)

Ann Robinson reviews the latest research from the top medical journals.

 


BMJ Review: Depression in Primary Care

9 Apr, 2019 | 02:11h | UTC

State of the Art Review: Depression in primary care: part 1—screening and diagnosis – The BMJ (free for a limited period)

Depression in primary care: part 2—management

 

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Use of vitamin D drops leading to kidney failure in a 54-year-old man – Canadian Medical Association Journal (free)

“Vitamin D toxicity is rare, but clinicians must be aware of the risks of vitamin D use to limit complications related to hypercalcemia”.

 


Review article: treatment options for functional dyspepsia – Alimentary Pharmacology and Therapeutics (free)

“None of the available therapies is effective in the majority of patients without being associated with major side effects.”

 


Ann Robinson’s weekly research reviews, 2 April 2019 – The BMJ Opinion (free)

Ann Robinson reviews the latest research from the top medical journals.

 


Alex Nowbar’s research reviews, 26 March 2019 – The BMJ Opinion (free)

Alex Nowbar reviews the latest research from the top medical journals.

 


A Clinical Overview of Off-label Use of Gabapentinoid Drugs – JAMA Internal Medicine (free for a limited period)

Related Meta-Analysis: Anticonvulsants in the Treatment of Low Back Pain and Lumbar Radicular Pain (free study and commentaries)

“Clinicians who prescribe gabapentinoids off-label for pain should be aware of the limited evidence and should acknowledge to patients that potential benefits are uncertain for most off-label uses.”

 


Why you should be a “medical conservative” – Lown Institute (free)

Original Article: Perspective: The Case for Being a Medical Conservative (free article and twitter thread)

“being a medical conservative means being skeptical about new medical advances until unbiased and high-quality evidence shows a clear benefit”

 


Schedules for Self-monitoring Blood Pressure: A Systematic Review – American Journal of Hypertension (free)

Home blood pressure should be measured for 3 days, increased to 7 only when mean blood pressure is close to a diagnostic or treatment threshold.”

 


Vitamin K for reversal of excessive vitamin K antagonist anticoagulation: a systematic review and meta-analysis – Blood Advances (free)

Our findings indicate that patients on VKA therapy who have an INR between 4.5 and 10.0 without bleeding are not likely to benefit from vitamin K administration in addition to temporary VKA cessation.”

 


Presented at the American College of Cardiology (ACC) 2019 Scientific Session.

Effect of Catheter Ablation vs Antiarrhythmic Drug Therapy on Mortality, Stroke, Bleeding, and Cardiac Arrest Among Patients With Atrial Fibrillation: The CABANA Randomized Clinical Trial – JAMA (free for a limited period)

Related Study: Effect of Catheter Ablation vs Medical Therapy on Quality of Life Among Patients With Atrial Fibrillation: The CABANA Randomized Clinical Trial – JAMA (free for a limited period)

Video Summary: Catheter Ablation vs Drug Therapy for Patients With Atrial Fibrillation: The CABANA Trial (free)

Editorial: Catheter Ablation for Atrial Fibrillation: Lessons Learned From CABANA (free for a limited period)

Commentary: Surgery no better than medication at preventing serious complications of atrial fibrillation – NIH News Releases (free)

 

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Associations of Dietary Cholesterol or Egg Consumption With Incident Cardiovascular Disease and Mortality – JAMA (free for a limited period)

Commentaries: Are Eggs Good Or Bad? How You Should Interpret This Latest Study – Forbes (free) AND Are eggs good or bad for you? New research rekindles the debate – STAT (free) AND Eggs are bad – then good – then bad again? What gives? – Diet Doctor (free)

 

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Evidence evolving on aspirin as prevention – ACP Internist (free)

Related: Randomized Trial: Aspirin for Primary Prevention of Cardiovascular Disease (link to abstract and commentaries) AND Randomized Trial: Effects of Aspirin for Primary Prevention in Persons with Diabetes (link to abstract and commentaries) AND Randomized Trial: Effect of Aspirin on All-Cause Mortality in the Healthy Elderly (link to abstract and commentaries) AND Meta-Analysis: Association of Aspirin Use for Primary Prevention with Cardiovascular Events and Bleeding Events (link to abstract and commentaries)

“In patients who have not had a prior cardiovascular event, aspirin’s protective effects are modest and may not necessarily outweigh its potential downsides (namely, risk of bleeding and hemorrhagic stroke).”

 


Signs and Symptoms That Rule out Community-Acquired Pneumonia in Outpatient Adults: A Systematic Review and Meta-Analysis – Journal of the American Board of Family Medicine (free)

Adults with an acute respiratory infection who have normal vital signs (temperature < 37,8 / respiratory rate < 20 / heart rate < 100) and a normal pulmonary examination are very unlikely to have CAP.

 


Reexamining Recommendations for Treatment of Hypercholesterolemia in Older Adults – JAMA (free for a limited period)

“This Viewpoint discusses the 2018 ACC/AHA cholesterol management guideline recommendation to consider statin treatment in adults aged >75 years with LDL levels 70-189 mg/dL, arguing that trial evidence does not support it…”

 


Christopher Martyn’s research reviews, 11 March 2019 – The BMJ Opinion (free)

Christopher Martyn reviews the latest research from the top medical journals.

 


Use of postmenopausal hormone therapy and risk of Alzheimer’s disease in Finland: nationwide case-control study – The BMJ (free)

Editorial: Menopausal hormone therapy and cognition (free)

Commentaries: Systemic Hormone Therapy Tied to Small Increase in Alzheimer’s Risk – NEJM Journal Watch (free) AND ‘Small’ increase in risk of Alzheimer’s disease with HRT use, study suggests – NHS Choices (free)

“The findings of this case-control study, with the modest effect sizes and substantial potential for bias, will not change how I counsel patients regarding benefits and risks of HT.” (from Journal Watch)

“Evidence is reassuring for women needing a few years’ treatment for menopausal symptoms” (from Editorial)

 


The war on ‘prediabetes’ could be a boon for pharma—but is it good medicine? – Science (free)

 

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Ann Robinson’s research reviews, 5 March 2019 – The BMJ Opinion (free)

Ann Robinson reviews the latest research from the top medical journals.

 


Paracetamol versus placebo for knee and hip osteoarthritis – Cochrane Library (free)

Summary: Paracetamol for treating people with hip or knee osteoarthritis – Cochrane Library (free)

Related: Paracetamol: widely used and largely ineffective (free)

 

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2018 Update on Pediatric Medical Overuse

27 Feb, 2019 | 00:43h | UTC

2018 Update on Pediatric Medical Overuse: A Review – JAMA Pediatrics (free for a limited period)

 

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Podcast: Genetic Testing in Primary Care

18 Feb, 2019 | 17:01h | UTC

Deprescribing benzodiazepine receptor agonists taken for insomnia: a review and key messages from practice guidelines – Polish Archives of Internal Medicine (free PDF)

Related: Guideline: Deprescribing Benzodiazepines (free guideline and resources) AND Position Statement: Reducing Inappropriate Medication Use & Polypharmacy (several articles and commentaries on the subject)

 

 


Urine Sediment Examination in the Diagnosis and Management of Kidney Disease: Core Curriculum 2019 – American Journal of Kidney Diseases (free for a limited period)

 

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Five Warning Signs of Overdiagnosis

11 Feb, 2019 | 00:05h | UTC

Viewpoint: Potential Excessive Testing at Scale: Biomarkers, Genomics, and Machine Learning – JAMA (free for a limited period)

 

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Incidence of sight‐threatening diabetic retinopathy in people with Type 2 diabetes mellitus and numbers needed to screen: a systematic review – Diabetic Medicine (free PDF)

Commentary: How often should patients with T2D be screened for retinopathy? – Univadis (free registration required)

Related: Evidence‐based Guidelines for Screening of Diabetic Retinopathy (free)

“This review supports lengthening of the screening interval of patients with Type 2 diabetes without retinopathy at last screening session”

 


Primary cervical screening with high risk human papillomavirus testing: observational study – The BMJ (free)

Commentaries: HPV cervical screening test switch ‘effective’, says pilot study – Cancer Research UK (free) AND Cervical screening intervals could be safely extended to at least five years – Pulse (free)

Related: USPSTF Statement: Screening for Cervical Cancer (free guidance and commentaries) AND Study: Little Benefit in Screening Women Aged 55 with a Negative HPV DNA test (link to abstract and commentaries) AND Randomized Trial: Cervical Cancer Screening with Cervical HPV Testing vs Cytology Testing (link to abstract and commentaries)

“The lower incidence of cervical intraepithelial neoplasia grade 3 or worse and cervical cancer at present screening intervals would strongly support the safety of extending the intervals to at least five years without increasing the risk of potentially life-threatening disease.”

 


Alex Nowbar’s research reviews, 5 February 2019 – The BMJ Opinion (free)

Alex Nowbar reviews the latest research from the top medical journals.

 


Comparing Automated Office Blood Pressure Readings With Other Methods of Blood Pressure Measurement for Identifying Patients With Possible Hypertension: A Systematic Review and Meta-analysis – JAMA Internal Medicine (link to abstract – $ for full-text)

Commentaries: Automated BP Readings More Accurate Than Manual Measurements – NEJM Journal Watch (free) AND Automated office BP readings best routine measures – MDedge Cardiology (free)

 

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2019 ACIP Adult Immunization Schedule

5 Feb, 2019 | 00:39h | UTC

Worldwide Dyslipidemia Guidelines

4 Feb, 2019 | 22:32h | UTC

American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults (free)

News Release: For older people, medications are common; AGS Beers Criteria aims to make them appropriate, too (free)

Commentary: AGS: Beers Criteria for Potentially Inappropriate Med Use in Older Adults Updated – MPR (free)

 

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