Radonovich et al. JAMA 2019 Sep 3;322(9):824-33
The advantage of N95 respirators over surgical masks in controlled settings were not demonstrated in preventing staff influenza infection in routine primary care.
Steels E, et al. Inflammopharmacology 2019 Jun;27(3):475-85.
Palmitoylethanolamide (PEA) cannot be recommended as a routine therapy for knee osteoarthritis in Australian primary care,
Osani et al. Korean J Intern Med 2019 Mar 15
Duloxetine (60-120 mg daily) appears to have a small to moderate beneficial effect on knee osteoarthritis pain and function at 3 months, compared to placebo.
Beadle et al. Ann Emerg Med 2016 Jul;68(1):1-9 e1.
Nasal inhalation of isopropyl alcohol provides clinically important relief from acute nausea, of at least a short duration, in community ambulatory patients
Bisson et al. Cochrane database of systematic reviews 2013 Dec 13(12):CD003388
Eye movement desensitisation and reprocessing (EMDR) appears to be effective for post-traumatic stress disorder (PTSD) symptoms.
Previous
Next
Journal reference: Singh M, Das RR. Zinc for the common cold. Cochrane Database of Systematic Reviews 2011, Issue 2. Art. No.: CD001364 [1]
Link: http://dx.doi.org/10.1002/14651858.CD001364.pub3
Published: 16 February 2011
 Evidence cookie says... |
Zinc administered within 24 hours of the symptoms of a common cold is associated with favourable outcomes but with some side-effects.
- ↓ cold symptom duration by ~ 1 day
- ↓ cold symptom severity (minimal)
- ↑ side-effects: bad taste (NNH = 7) and nausea (NNH = 12)
It is premature to routinely recommend zinc therapy for the common cold. It is reasonable to direct patients seeking community remedies towards zinc rather than other common treatments (echinacea, vitamin C).
Note: there are limitations to the evidence. See below for more details. |
Continue reading
Permanent link to this article: https://evidencebasedmedicine.com.au/?p=1393
Journal reference: Ray KK, Seshasai SR, Erqou S, et al. Statins and all-cause mortality in high-risk primary prevention: a meta-analysis of 11 randomized controlled trials involving 65 229 participants. Archives of Internal Medicine, 2010; 170(12): 1024-31 [1]
Link: http://archinte.ama-assn.org/cgi/content/abstract/170/12/1024
Published: 28 June 2010
Evidence cookie says... |
Statins were not associated with a benefit to all-cause mortality in a primary prevention setting.
Although there is some ambiguity with the data, it is very unlikely that statins are of clinical benefit in patients with low and moderate absolute cardiovascular risk.
Until more definitive evidence becomes available, statins in the primary prevention setting should be reserved for those patients who are at high risk according to the 2005 lipid management guidelines [2] |
Continue reading
Permanent link to this article: https://evidencebasedmedicine.com.au/?p=1341
Journal reference: van Boxel OS, van Oijen MGH, Hagenaars MP, et al. Cardiovascular and gastrointestinal outcomes in clopidogrel users on proton pump inhibitors: results of a large Dutch cohort study. Am J Gastroenterol 2010; 105: 2430–6 [1]
Link: http://dx.doi.org/10.1038/ajg.2010.334
Published: 24 August 2010
Evidence cookie says... |
Concurrent proton pump inhibitors (PPIs) may increase the risk of cardiovascular outcomes in patients taking clopidogrel.
The results of this specific study are likely invalid due to methodological biases (see below for details).
There is substantial uncertainty in the evidence base generally.
GPs should be guided by a precautionary principle:
- it is reasonable to prescribe PPIs to those with clear indications
- new and ongoing therapy should be assessed from the perspective that PPIs might increase the risk of harm
|
Continue reading
Permanent link to this article: https://evidencebasedmedicine.com.au/?p=1322
Journal reference: Ernst E. Deaths after chiropractic: a review of published cases. Int J Clin Pract, July 2010; 64(8): 1162-5 [1]
Link: http://dx.doi.org/10.1111/j.1742-1241.2010.02352.x
Published: 16 June 2010
Evidence cookie says... |
Chiropractic, specifically, high-velocity, short-lever thrusts of the upper spine with rotation is associated with numerous deaths.
Most of the deaths were secondary to vascular accidents of the vertebrobasilar system.
There is no good evidence for this therapy for any medical condition.
General practitioners should advice their patients considering chiropractic therapy to avoid upper cervical manipulation. |
Continue reading
Permanent link to this article: https://evidencebasedmedicine.com.au/?p=1312
Journal reference: Rajaraman P, Simpson J, Neta G, et al. Early life exposure to diagnostic radiation and ultrasound scans and risk of childhood cancer: case-control study. BMJ 2011; 342: d472 [1]
Link: http://dx.doi.org/10.1136/bmj.d472
Published: 10 February 2011
Evidence cookie says... |
The excess risk of childhood cancer from diagnostic imaging in utero and early infancy remains unclear.
This study was underpowered for the results to be meaningful.
Nevertheless, the results suggest that in utero ultrasound is unlikely to be associated with childhood cancer.
Following a precautionary principle, the usual practice of avoiding diagnostic radiation in pregnant women and young children should continue. |
Continue reading
Permanent link to this article: https://evidencebasedmedicine.com.au/?p=1295
Journal reference: Large M, Sharma, S, Compton MT, et al. Cannabis use and earlier onset of psychosis. Arch Gen Psychiatry 2011: published online 7 February 2011 [1]
Link: http://dx.doi.org/10.1001/archgenpsychiatry.2011.5
Published: 7 February 2011
Evidence cookie says... |
Cannabis may be causally related to psychotic illness but the evidence remains unclear.
This meta-analysis demonstrates an association between cannabis use and earlier onset of psychosis.
There are limitations in the reliability of the results; the association should not be considered definitive and causal inferences should made with caution.
See below for more details. |
Continue reading
Permanent link to this article: https://evidencebasedmedicine.com.au/?p=1280
It is with some regret that Morsels of Evidence will reduce its publication schedule to once weekly on Wednesdays. Unfortunately, the staff and contributors have other obligations that prevent them dedicating the necessary time for more frequent publication.
Permanent link to this article: https://evidencebasedmedicine.com.au/?p=1417
Journal reference: Bleicher K, Naganathan V, Cumming RG, et al. Prevalence and treatment of osteoporosis in older Australian men: findings from the CHAMP study. MJA 2010;193:387-391 [1]
Link: http://www.mja.com.au/public/issues/193_07_041010/ble10100_fm.html
Published: 4 October 2010
Evidence cookie says... |
Osteoporosis is very common in men aged over 70 years and probably under-recognised and undertreated; 25% of participants had osteoporosis.
However, only 5% of the participants had a history of low trauma fracture. Even in these men, the rate of treatment was very low.
Remember to discuss osteoporosis risk in older men and ask for a history of low impact trauma. If bisphosphonate therapy is initiated, remember to co-prescribe oral calcium and vitamin D. |
Continue reading
Permanent link to this article: https://evidencebasedmedicine.com.au/?p=228
Journal reference: Myers MG, Godwin M, Dawes M, et al. Conventional versus automated measurement of blood pressure in primary care patients with systolic hypertension: randomised parallel design controlled trial. BMJ 2011; 342: d286 [1]
Link: http://dx.doi.org/10.1136/bmj.d286
Published: 7 February 2011
Evidence cookie says... |
Automated blood pressure measurement is significantly closer to waking ambulatory BP than conventional manual measurement in a primary care clinic setting.
Mean over-estimation of systolic blood pressure:
- automated: 2.3 mmHg
- conventional: 6.5 mmHg
Procedure: patient left alone, average of 5 consecutive blood pressure readings spaced every 2 minutes
Caution: there is a narrow range of participants in this study. See below for more details |
Continue reading
Permanent link to this article: https://evidencebasedmedicine.com.au/?p=1229
Journal reference: Chlebowski R, Anderson G, Gass M, et al. Estrogen plus progestin and breast cancer incidence and mortality in postmenopausal women. JAMA. 2010; 304 (15):1684-1692. [1]
Link: http://dx.doi.org/10.1001/jama.2010.1500
Published: 20 October 2010
Evidence cookie says... |
Combined oestrogen and progestin HRT is associated with increased risk of invasive breast cancer, node-positivity, and all cause mortality compared to placebo.
- ↑ 25% risk of invasive breast cancer
- NNH = 114; 11 years follow up with 5.6 years of HRT
- ↑ 78% risk of node-positivity at time of diagnosis of breast cancer
The associated higher risk of breast cancer death and all cause mortality had wide confidence intervals. They need to be viewed with caution.
HRT should be used only when there is clear benefit. GPs should discuss the increased risks of breast cancer and mortality. Short-term use is prudent. |
Continue reading
Permanent link to this article: https://evidencebasedmedicine.com.au/?p=1062
Load more
Recent Comments