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Intensive treatment of hypertension to a SBP
Commentary on: Williamson JD, Supiano MA, Applegate WB, et al.. Intensive vs standard blood pressure control and cardiovascular disease outcomes in adults aged ≥75 years. A randomized clinical trial. JAMA 2016;315:2673–82 . Context There is uncertainty regarding optimal blood pressure (BP) targets in treating hypertension. Most recent guidelines have recommended a systolic target of <140 mm Hg. The Systolic Blood Pressure Intervention Trial (SPRINT) compared cardiovascular (CV) outcomes in non-diabetic hypertensive patients randomised to standard (systolic blood pressure (SBP) <140 mm&nbs...
Source: Evidence-Based Medicine - January 23, 2017 Category: Internal Medicine Authors: Weber, M. A. Tags: Palliative care, Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Stroke, Hypertension, Ischaemic heart disease, Renal medicine, Ethics Therapeutics/Prevention Source Type: research

Morphine exposure in preterm infants correlates with impaired cerebellar growth and poorer neurodevelopmental outcome
This study included 136 infants born at 24–32 weeks gestational age who underwent magnetic resonance imaging of the brain near birth and...
Source: Evidence-Based Medicine - November 22, 2016 Category: Internal Medicine Authors: McPherson, C. Tags: Clinical trials (epidemiology), Epidemiologic studies, Pain (neurology), Stroke, Pain (palliative care), Radiology, Drugs: musculoskeletal and joint diseases, Clinical diagnostic tests, Radiology (diagnostics) Aetiology/Harm Source Type: research

The 'surprise' question may improve the accuracy of GPs in identifying death in patients with advanced stage IV solid-cell cancer
Commentary on: Moroni M, Zocchi D, Bolognesi D, et al.; on behalf of the SUQ-P group. The ‘surprise’ question in advanced cancer patients: a prospective study among general practitioners. Palliat Med 2014;28:,959–64. Context The ‘surprise’ question has been developed in order to improve the ability of clinicians to identify patients who are at risk of dying in the near future. The question, ‘Would I be surprised if this patient died in the next year?’ shifts the focus away from precise identification of dying patients to identifying patients who might be dying.1 This may enable mor...
Source: Evidence-Based Medicine - March 17, 2015 Category: Internal Medicine Authors: Rhee, J., Clayton, J. M. Tags: EBM Prognosis, Pancreas and biliary tract, Palliative care, Epidemiologic studies, General practice / family medicine, Stroke, Prostate Source Type: research

Psychological therapies help reduce headache and non-headache pain in children and adolescents
Commentary on: Eccleston C, Palermo TM, Williams AC, et al.. Psychological therapies for the management of chronic and recurrent pain in children and adolescents. Cochrane Database Syst Rev 2014;5:CD003968. Context Chronic and recurrent pain, especially in the head, abdomen and limbs affects up to 30% of children and adolescents.1 Pain can be severely disabling, disrupting school and social activities and if left untreated, may extend towards adulthood. Increasing evidence shows that psychological factors are pivotal in the transition from acute to chronic disabling pain. As a result, psychological interventions have been ...
Source: Evidence-Based Medicine - November 19, 2014 Category: Internal Medicine Authors: Vlaeyen, J. W. S., Gatzounis, R. Tags: Palliative care, Clinical trials (epidemiology), Headache (including migraine), Pain (neurology), Stroke, Child and adolescent psychiatry, Complementary medicine Therapeutics Source Type: research

Neither ibuprofen nor steam improves symptom control compared with paracetamol in patients with acute respiratory tract infections in primary care
Commentary on: Little P, Moore M, Kelly J, et al.. Ibuprofen, paracetamol, and steam for patients with respiratory tract infections in primary care: pragmatic randomised factorial trial. BMJ 2013;347:f6041. Context The achievement of symptom control in patients with respiratory infections is an ongoing challenge, particularly within primary care. Patients and clinicians often view antibiotics, alongside other supportive medication, as the most expeditious intervention to achieve this goal. While we have learnt that antibiotics provide only very limited benefit in cases when bacterial infection is not suspected,1 2 the effe...
Source: Evidence-Based Medicine - May 19, 2014 Category: Internal Medicine Authors: Schuetz, P. Tags: General practice / family medicine, Influenza, Otitis, Pain (neurology), Stroke, Ischaemic heart disease, Pain (palliative care), Drugs: musculoskeletal and joint diseases, Ear, nose and throat/otolaryngology Therapeutics Source Type: research

Long-term aspirin use and neovascular age-related macular degeneration: association or causation?
Commentary on: Liew G, Mitchell P, Wong TY, et al.. The association of aspirin use with age-related macular degeneration. JAMA Intern Med 2013;173:258–64. Context Aspirin is used by many for temporary pain relief, rheumatological conditions and where indicated, cardioprotection. However, recent findings from observational studies have raised the possibility that regular aspirin use may also increase the risk of some forms of age-related macular degeneration (AMD). Methods Liew and colleagues examined the relationship between long-term, low-dose aspirin use and risk of AMD in an Australian population-based cohort of 2...
Source: Evidence-Based Medicine - January 22, 2014 Category: Internal Medicine Authors: Christen, W. G. Tags: EBM Aetiology, Smoking and tobacco, Epidemiologic studies, Immunology (including allergy), Drugs: cardiovascular system, Pain (neurology), Stroke, Hypertension, Ophthalmology, Pain (palliative care), Pain (anaesthesia), Diabetes, Health education, Smoking Source Type: research