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Peripartum antidepressant use is associated with an increased risk of postpartum haemorrhage
Commentary on: Palmsten K, Hernández-Díaz S, Huybrechts KF, et al.. Use of antidepressants near delivery and risk of postpartum hemorrhage: cohort study of low income women in the United States. BMJ 2013;347:f4877. Context Increased incidence of postpartum haemorrhage (PPH) is reported in a number of high-resource settings since the 1990s. The increase appears unrelated to factors such as rising rates of caesarean sections or increasing maternal age.1 Recent studies have investigated the association between antidepressant use at different stages of pregnancy and PPH, with two studies demonstrating a 1.20-fol...
Source: Evidence-Based Medicine - March 19, 2014 Category: Internal Medicine Authors: Ford, J. B., Morris, J. M. Tags: EBM Aetiology, Health policy, Epidemiologic studies, Drugs: CNS (not psychiatric), Stroke, Pregnancy, Anxiety disorders (including OCD and PTSD), Child and adolescent psychiatry, Mood disorders (including depression), Drugs: musculoskeletal and joint dise Source Type: research

Aspirin prophylaxis in people without prior cardiovascular disease does not lead to reductions in cardiovascular death or cancer mortality
Commentary on: Seshasai SR, Wijesuriya S, Sivakumaran R, et al.. Effect of aspirin on vascular and nonvascular outcomes: meta-analysis of randomized controlled trials. Arch Intern Med 2012;172:209–16. Context Prophylactic antiplatelet therapy with aspirin reduces the risk of non-fatal myocardial infarction (MI), non-fatal stroke and vascular death in patients with known cardiovascular disease (CVD) and is of net benefit. The absolute reduction in recurrent events significantly exceeds the increase in major bleeding.1 However, the role of aspirin in primary prevention of CVD is not clear. According to the Antithrombot...
Source: Evidence-Based Medicine - March 19, 2013 Category: Internal Medicine Authors: Farooq, M. U., Gorelick, P. B. Tags: Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Stroke, Hypertension, Prevention, Ischaemic heart disease Online articles Source Type: research

Tranexamic acid reduces blood transfusion in surgical patients while its effects on thromboembolic events and mortality are uncertain
Commentary on: Ker K, Edwards P, Perel P, et al.. Effect of tranexamic acid on surgical bleeding: systematic review and cumulative meta-analysis. BMJ 2012;344:e3054. Context Surgical trauma leads to the activation of local fibrinolysis, and surgical bleeding can be significant in certain types of surgery leading to acute anaemia and the need for blood transfusion. Clinical trends have led to reductions in acceptable haemoglobin transfusion thresholds. However, growing evidence from clinical and experimental studies suggests that acute haemodilutional anaemia may reduce tissue oxygen delivery and increase perioperative morb...
Source: Evidence-Based Medicine - March 19, 2013 Category: Internal Medicine Authors: Raveendran, R., Wong, J. Tags: Clinical trials (epidemiology), Epidemiologic studies, Haematology (incl blood transfusion), Drugs: cardiovascular system, Stroke, Interventional cardiology, Ischaemic heart disease, Venous thromboembolism, Pulmonary embolism Therapeutics Source Type: research

Single-tablet double-dose famotidine plus ibuprofen decreases endoscopic upper GI ulcers compared with ibuprofen alone
Commentary on: Laine L, Kivitz AJ, Bello AE, et al.. Double-blind randomized trials of single-tablet ibuprofen/high-dose famotidine vs. ibuprofen alone for reduction of gastric and duodenal ulcers. Am J Gastroenterol 2012;107:379–86. Context Non-steroidal anti-inflammatory drugs (NSAID) are widely prescribed worldwide. However, NSAID use frequently accompanies gastrointestinal (GI) injury including complications such as bleeding and perforation. Therefore co-therapy with gastroprotective drugs especially for those at risk has been advocated in current guidelines1 in which proton-pump inhibitors (PPI) and misoprostol ...
Source: Evidence-Based Medicine - January 17, 2013 Category: Internal Medicine Authors: Sugano, K. Tags: Clinical trials (epidemiology), Small intestine, Stomach and duodenum, Drugs: cardiovascular system, Stroke, Drugs: musculoskeletal and joint diseases Therapeutics Source Type: research

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