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Specialty: Internal Medicine
Source: Evidence-Based Medicine
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Total 156 results found since Jan 2013.
Cranberry capsules (2 taken twice daily for an average 38 days) reduce the risk of postoperative urinary tract infection in women undergoing benign gynaecological surgery involving intraoperative catheterisation
This study investigates the use of cranberry capsules to prevent postoperative UTI following benign gynaecological surgery. Methods This randomised double-blind, placebo-controlled trial investigates whether cranberry (2 capsules two times per day, equivalent to two 8 oz servings of cranberry juice) taken for approximately 6 weeks after gynaecological surgery reduces postoperative UTI. Participants...
Source: Evidence-Based Medicine - July 24, 2015 Category: Internal Medicine Authors: Dieter, A. A. Tags: Epidemiologic studies, Immunology (including allergy), Urinary tract infections, Drugs: CNS (not psychiatric), Stroke, Vulvovaginal disorders, Urinary tract infections Therapeutics/Prevention Source Type: research
Lowering diastolic blood pressure in non-proteinuric hypertension in pregnancy is not harmful to the fetus and is associated with reduced frequency of severe maternal hypertension
Commentary on: Magee LA, von Dadelszen P, Rey E, et al. Less-tight versus tight control of hypertension in pregnancy. N Engl J Med 2015;372:407–17. Context Guidelines recommend lowering blood pressure (BP) below 140/90 mm Hg in adults <60 years to prevent cardiovascular complications.1 During pregnancy, lowering BP below 160/110 mm Hg is universally endorsed; however, maternal and fetal benefits of targets below 140/90 mm Hg are not clear. Some meta-analyses suggest a possible reduction in fetal birth weight associated with lowering mildly elevated BP.2 However, other analyses fo...
Source: Evidence-Based Medicine - July 24, 2015 Category: Internal Medicine Authors: August, P. Tags: Drugs: cardiovascular system, Stroke, Hypertension, Pregnancy, Renal medicine Therapeutics/Prevention Source Type: research
Coronary artery bypass surgery continues to remain the treatment of choice for multivessel coronary artery disease even in the era of new-generation drug-eluting stents
Commentary on: Park SJ, Ahn JM, Kim YH, et al; BEST Trial Investigators. Trial of everolimus-eluting stents or bypass surgery for coronary disease. N Engl J Med 2015;372:1204–12. Context Multivessel coronary artery disease (MVCAD) may be found in patients subjected to coronary angiography. It is treated with coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI). The expanded use of PCI, following development of drug-eluting stents (DES), necessitated comparison of its outcomes with CABG (gold standard therapy). The SYNTAX (SYNergy between PCI with TAXUS and Cardiac Surgery) trial favoured...
Source: Evidence-Based Medicine - July 24, 2015 Category: Internal Medicine Authors: Mohr, F. W., Davierwala, P. M. Tags: Clinical trials (epidemiology), Drugs: cardiovascular system, Stroke, Interventional cardiology, Ischaemic heart disease, Venous thromboembolism, Radiology, Clinical diagnostic tests, Radiology (diagnostics) Therapeutics/Prevention Source Type: research
High-sensitivity cardiac troponin T in isolation has limited diagnostic utility in identifying cardiac causes of syncope
This study examines the diagnostic accuracy of high-sensitivity cardiac troponin T (cTnThs) for cardiac syncope and its predictive value for short-term (30 days) or medium-term (180 days) adverse events. Methods This was a secondary analysis of pre-existing prospective observational data of adult syncope patients from a single-centre...
Source: Evidence-Based Medicine - July 24, 2015 Category: Internal Medicine Authors: Thiruganasambandamoorthy, V., Perry, J. J. Tags: EBM Diagnosis, Drugs: cardiovascular system, Stroke, Ischaemic heart disease, Venous thromboembolism, Pulmonary embolism, Surgical diagnostic tests Source Type: research
The mortality rate in England between 2007 and 2012 was not associated with the quality of primary care in an established pay for performance programme
This study aimed to examine the relationship between primary care performance of quality indicators included in the QOF and changes in mortality. Methods This was an analysis of a longitudinal data...
Source: Evidence-Based Medicine - July 24, 2015 Category: Internal Medicine Authors: Fleetcroft, R. Tags: EBM Quality improvement, Medical management, Clinical trials (epidemiology), Epidemiologic studies, General practice / family medicine, Drugs: cardiovascular system, Stroke, Hypertension, Diet, Ischaemic heart disease, Renal medicine, Guidelines Source Type: research
Potential cost-savings may be considerable with management of hypertension according to updated US hypertension guidelines, but for women aged 35-44 years these benefits are unlikely
Commentary on: Moran AE, Odden MC, Thanataveerat A, et al. Cost-effectiveness of hypertension therapy according to 2014 guidelines. N Engl J Med 2015;372:447–55. Context The number of people with hypertension is anticipated to increase despite greater awareness of the condition as a risk factor for cardiovascular disease (CVD) and more options for treatment. Clinical guidelines are evidence-based recommendations used to inform clinician practice when treating an individual patient. Regular updates of guidelines are important to ensure their ongoing relevance. Moran and colleagues investigated the potential cost impli...
Source: Evidence-Based Medicine - July 24, 2015 Category: Internal Medicine Authors: Cadilhac, D. A., Kim, J. Tags: Health policy, Drugs: cardiovascular system, Stroke, Hypertension, Health economics, Health service research, Guidelines Economic analysis Source Type: research
Restrictive red blood cell transfusion strategies appear safe in most clinical settings
Commentary on: Holst LB, Petersen MW, Haase N, et al. Restrictive versus liberal transfusion strategy for red blood cell transfusion: systematic review of randomised trials with meta-analysis and trial sequential analysis. BMJ 2015;350:h1354. Context Substantial progress has been made in generating data to make evidence-based recommendations for red blood cell (RBC) transfusion. Findings from clinical trials suggest that in most clinical settings, a restrictive transfusion strategy, where RBCs are transfused once haemoglobin levels fall below either 7 or 8 g/dL, does not impact mortality compared with liberal transfus...
Source: Evidence-Based Medicine - September 24, 2015 Category: Internal Medicine Authors: Roubinian, N. H., Carson, J. L. Tags: Clinical trials (epidemiology), Epidemiologic studies, Haematology (incl blood transfusion), Drugs: cardiovascular system, Stroke, Interventional cardiology, Ischaemic heart disease, Renal medicine Therapeutics/Prevention Source Type: research
An IVC filter and anticoagulation for 3 months is unlikely to show a benefit over anticoagulation alone for high-risk patients with acute pulmonary embolism
Commentary on: Mismetti P, Laporte S, Pellerin O, et al; PREPIC2 Study Group. Effect of a retrievable inferior vena cava filter plus anticoagulation vs anticoagulation alone on risk of recurrent pulmonary embolism: a randomized clinical trial. JAMA 2015;313:1627–35. Context Placement of an inferior vena cava (IVC) filter to prevent pulmonary embolism (PE) is recommended by multidisciplinary consensus guidelines only when anticoagulation is contraindicated, has resulted in a complication or has failed.1 2 Oddly, the only prospective randomised long-term filter efficacy study that demonstrated a reduction in the recurr...
Source: Evidence-Based Medicine - September 24, 2015 Category: Internal Medicine Authors: Hoffer, E. K. Tags: Journalology, Clinical trials (epidemiology), Drugs: cardiovascular system, Heart failure, Stroke, Venous thromboembolism, Pulmonary embolism, Ethics Therapeutics/Prevention Source Type: research
Ezetimibe provides incremental reduction in risk for cardiovascular events and need for revascularisation following an acute coronary syndrome
Commentary on: Cannon CP, Blazing MA, Giugliano RP, et al., IMPROVE-IT Investigators. Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes. N Engl J Med 2015;372:2387–97. Context Use of statin therapy to treat dyslipidemia in patients with established coronary artery disease is the standard of care worldwide. Given the negative results of a number of trials that tested the use of adjuvant lipid-lowering therapies against a statin background, there has been great scepticism about whether or not non-statin drugs provide incremental benefit.1–3 Ezetimibe inhibits the absorption of both dietary and bili...
Source: Evidence-Based Medicine - September 24, 2015 Category: Internal Medicine Authors: Toth, P. P. Tags: Health policy, Epidemiologic studies, Genetics, Immunology (including allergy), Vaccination / immunisation, Stroke, Diet, Ischaemic heart disease, Health economics, Health service research, Lipid disorders Therapeutics/Prevention Source Type: research
Combined oral contraceptives and risk of venous thromboembolism: there is higher risk in new generations compared to second generations, but paradoxically not in norgestimate-containing-pills
This study examines the VTE risk associated with COC use in two large UK databases. Methods...
Source: Evidence-Based Medicine - September 24, 2015 Category: Internal Medicine Authors: Plu-Bureau, G. Tags: Smoking and tobacco, Epidemiologic studies, General practice / family medicine, Drugs: cardiovascular system, Stroke, Contraception, Drugs: obstetrics and gynaecology, Family planning, Alcohol, Health education, Smoking Aetiology/Harm Source Type: research
Low-molecular-weight heparin offers no benefit to patients with unexplained recurrent miscarriage in future pregnancy
Commentary on: Schleussner E, Kamin G, Seliger G, et al., ETHIG II group. Low-molecular-weight heparin for women with unexplained recurrent pregnancy loss: a multicenter trial with a minimislation randomisation scheme. Ann Intern Med 2015;162:601–9 . Context Recurrent miscarriage (RM) has been shown to affect between 1% and–3% of couples trying to conceive and up to 5% of those with two consecutive miscarriages are included. While there are many known risk factors for RM no underlying cause is found in nearly 50% of couples.1 The treatment of RM is usually aimed at the cause, which leaves us with very little to...
Source: Evidence-Based Medicine - November 24, 2015 Category: Internal Medicine Authors: Field, K. Tags: Journalology, Drugs: cardiovascular system, Stroke, Pregnancy, Ethics Therapeutics/Prevention Source Type: research
Mediterranean diet may reduce Alzheimer's risk
This study included 447...
Source: Evidence-Based Medicine - November 24, 2015 Category: Internal Medicine Authors: Psaltopoulou, T., Sergentanis, T. N. Tags: Smoking and tobacco, Clinical trials (epidemiology), Dementia, Drugs: CNS (not psychiatric), Stroke, Hypertension, Diet, Memory disorders (psychiatry), Psychiatry of old age, Lipid disorders, Health education, Smoking Therapeutics/Prevention Source Type: research
Risk of new-onset diabetes with statin use should not be overemphasised
This study examined diabetes outcomes among Tricare beneficiaries who were evaluated between 1 October 2003 and 1 March 2012. Participants were divided into statin users and non-users. Patients who, at baseline, had a pre-existing disease indicative of cardiovascular diseases, or any positive element of the Charlson comorbidity index, were excluded. A propensity score, using 42 baseline characteristics, was generated to match statin users and non-users. The main measurements included new-onset diabetes, diabetic complications and overweight/obesity. Findings...
Source: Evidence-Based Medicine - November 24, 2015 Category: Internal Medicine Authors: Chiang, C.-E., Wang, K.-L. Tags: Health policy, Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Stroke, Ischaemic heart disease, Diabetes Aetiology/Harm Source Type: research
Sugar-sweetened beverage consumption is linked to global adult morbidity and mortality through diabetes mellitus, cardiovascular disease and adiposity-related cancers
Commentary on: Singh GM, Micha R, Khatibzadeh S, et al., Global Burden of Diseases Nutrition and Chronic Diseases Expert Group (NutriCoDE). Estimated global, regional, and national disease burdens related to sugar-sweetened beverage consumption in 2010. Circulation 2015;132:639–66 . Context Obesity and obesity-related non-communicable diseases are global health burdens associated with all-cause and cause-specific mortality, economic costs and impaired quality of life.1–3 Sugar-sweetened beverage (SSB) consumption has been linked with obesity and has long been thought to contribute to cardiometabolic diseases th...
Source: Evidence-Based Medicine - November 24, 2015 Category: Internal Medicine Authors: Ruff, R. R. Tags: Epidemiologic studies, Drugs: cardiovascular system, Stroke, Hypertension, Diet, Obesity (nutrition), Dentistry and oral medicine, Diabetes, Health education Aetiology/Harm Source Type: research
Current 10-year atherosclerotic cardiovascular disease risk threshold for statin eligibility is cost-effective for primary prevention
Commentary on: Pandya A, Sy S, Cho S, et al. Cost effectiveness of 10-year risk thresholds for initiation of statin therapy for primary prevention of cardiovascular disease. JAMA 2015;314: 142–50 . Context The American College of Cardiology American Heart Association (ACC/AHA) cholesterol guidelines replaced the National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATP III) in 2013,1 a change that was accompanied by significant controversy.2 Notable among the criticisms was that the pooled cohort equations (PCE) overestimates risk and coupled with the relatively lenient risk threshold (10-year PCE &g...
Source: Evidence-Based Medicine - November 24, 2015 Category: Internal Medicine Authors: Yeboah, J. Tags: Health policy, Epidemiologic studies, Drugs: cardiovascular system, Neuromuscular disease, Stroke, Ischaemic heart disease, Musculoskeletal syndromes, Health economics, Health service research Economic analysis Source Type: research
