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.
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Journal reference: Ogawa T, Akahane M, Koike S, et al. Outcomes of chest compression only CPR versus conventional CPR conducted by lay people in patients with out of hospital cardiopulmonary arrest witnessed by bystanders: nationwide population based observational study. BMJ 2011; 342: c7106 [1]
Link: http://dx.doi.org/10.1136/bmj.c7106
Published: 27 January 2011
 Evidence cookie says... |
Conventional CPR may be associated with better rates of survival than chest compressions only when conducted by lay people in out of hospital arrests.
However, evidence from observation studies, though interesting, are methodologically weak and are not definitive.
Any CPR is better than none. The Australian Resuscitation Council CPR guideline remains relevant: [2]
- chest compression ventilation ratio, 30:2
- if unable or unwilling to provide rescue breaths, chest compression only at 100 per minute
See below for more details. |
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Permanent link to this article: https://evidencebasedmedicine.com.au/?p=1116
Journal reference: Barbosa-Cesnik C, Brown MB, Buxton M, et al. Cranberry juice fails to prevent recurrent urinary tract infection: results from a randomised placebo-controlled trial. Clinical Infectious Diseases. 2011; 52(1): 23-30 [1]
Link: http://dx.doi.org/10.1093/cid/ciq073
Published: 1 January 2011
Evidence cookie says... |
Cranberry juice is not associated with a lower incidence of UTI recurrence than placebo juice in young, sexually active college women.
This was a well conducted randomised controlled trial and provides moderate-high level evidence.
Prior studies supporting the use of cranberry offered only low/low-moderate level evidence.
Cranberry products are likely to be safe but come at substantial cost to the individual consumer. Australian general practitioners should not recommend or promote cranberry as an effective therapy for the prevention of urinary tract infections. |
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Permanent link to this article: https://evidencebasedmedicine.com.au/?p=1096
Journal reference: Freeman EW, Guthrie KA, Caan B, et al. Efficacy of escitalopram for hot flashes in healthy menopausal women: a randomized controlled trial. JAMA. 2011; 305(3): 267-74 [1]
Link: http://dx.doi.org/10.1001/jama.2010.2016
Published: 19 January 2011
Evidence cookie says... |
Escitalopram (Lexapro) is probably associated with a mild improvement in the frequency and severity of hot flushes in peri-menopausal women.
Up to 70% of the improvement in hot flushes can be attributed to non-drug mediated effects.
Escitalopram like other SSRI is a valid non-hormonal therapeutic option for hot flushes though with limited efficacy.
This study is subject to possible funding bias.
Note: escitalopram is not PBS listed or TGA approved for this indication; prescribers must provide a private prescription and inform patients that it is being used “off-label”. |
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Permanent link to this article: https://evidencebasedmedicine.com.au/?p=1075
Journal reference: Trelle S, Reichenbach S, Wandel S, et al. Cardiovascular safety of non-steroidal anti-inflammatory drugs: network meta-analysis. BMJ 2011; 342:c7086 [1]
Link: http://dx.doi.org/10.1136/bmj.c7086
Published: 11 January 2011
Evidence cookie says... |
Non-steroidal anti-inflammatory drugs (NSAIDs) appear to be associated with increased cardiovascular risks.
Naproxen appears to be associated with the least cardiovascular harm.
General practitioners should:
- avoid NSAIDs in patients with elevated cardiovascular risk
- avoid long-term use of NSAIDs
Note: there remains substantial uncertainly and the reliability of the evidence is limited. See below for more details. |
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Permanent link to this article: https://evidencebasedmedicine.com.au/?p=1173
Journal reference: Pasternak B, Hviid A. Use of acyclovir, valacyclovir, and famciclovir in the first trimester of pregnancy and the risk of birth defects. JAMA 2010;304(8):859-866 [1]
Link: http://dx.doi.org/10.1001/jama.2010.1206
Published: 25 August 2010
Evidence cookie says... |
No association was found between the use of aciclovir (Zovirax), or valaciclovir (Valtrex), in early pregnancy and major birth defects.
Too few participants were exposed to famciclovir (Famvir) for meaningful analysis.
Aciclovir is the most widely studied antiviral. It should be antiherpetic antiviral of choice in early pregnancy.
Note: there are some limitations in this study that may underestimate birth defects. These drugs have not been definitively determined safe in pregnancy. |
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Permanent link to this article: https://evidencebasedmedicine.com.au/?p=1046
Journal reference: Makrides M, Gibson R, McPhee A, et al. Effect of DHA supplementation during pregnancy on maternal depression and neurodevelopment of young children: a randomized controlled trial. JAMA. 2010; 304(15): 1675-1683 [1]
Link: http://dx.doi.org/10.1001/jama.2010.1507
Published: 20 October 2010
Evidence cookie says... |
Docosahexanoic acid (DHA) supplements in the later half of pregnancy are not associated with improvements in maternal depression or infant neurodevelopment.
DHA supplements were associated with fewer pre-term deliveries less than 34 weeks but more post-term deliveries by induction and caesarian section. These findings are of unclear clinical significance.
There remains no compelling evidence for routine use of DHA supplements in pregnancy. |
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Permanent link to this article: https://evidencebasedmedicine.com.au/?p=989
Journal reference: Galan P, Kesse-Guyot E, Czernichow S, et al. Effects of B vitamins and omega 3 fatty acids on cardiovascular diseases: a randomised placebo controlled trial. BMJ 2010; 341:c6273 [1]
Link: http://dx.doi.org/10.1136/bmj.c6273
Published: 29 November 2010
Evidence cookie says... |
B-vitamin and low dose omega-3 fatty acid supplements are not associated with better vascular outcomes in people with ischaemic heart disease and stroke.
The routine use of these interventions for secondary prevention of cardiovascular disease is not supported by the evidence base.
Clinical attention should be directed at known efficacious therapies that lower cardiovascular risk.
Note: the study findings are likely applicable within some limitations. See below for more details. |
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Permanent link to this article: https://evidencebasedmedicine.com.au/?p=993
Journal reference: Gopinath B, Wang JJ, Kifley A, et al. Five-year incidence and progression of thyroid dysfunction in an older population. Internal Medicine Journal, 2010;40(9):642–649 [1]
Link: http://dx.doi.org/10.1111/j.1445-5994.2009.02156.x
Published: 15 September 2010
Evidence cookie says... |
The rate of progression from subclinical hypothyroidism to overt hypothyroidism is about 1 in 6 for people over five years for those aged 55 years or greater.
Female gender, obesity and a TSH > 2.0 mIU/L were all associated with an increased 5-year incidence of thyroid dysfunction.
Note: caution should be taken to avoid over-generalising this data; in itself it does not support any specific management strategy. |
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Permanent link to this article: https://evidencebasedmedicine.com.au/?p=182
Journal reference: Parker C, Coupland C, Hippisley-Cox J. Antipsychotic drugs and risk of venous thromboembolism: nested case-control study. BMJ 2010;341:c4245. [1]
Link: http://dx.doi.org/10.1136/bmj.c4245
Published: 21 September 2010
Evidence cookie says... |
Antipsychotic drugs are associated with a 32% increased risk of venous thromboembolism (VTE).
The increased risk is higher with:
- new users of antipsychotics: ↑ 97%
- atypical antipsychotics: ↑ 73%
- low potency antipsychotics: ↑ 99%
- and multiple antipsychotics: ↑ 99%
The increase in absolute risk is low enough that this should not deter antipsychotic use for standard clinical indications for these drugs.
However, caution should be particularly taken in using low potency atypical antipsychotics (e.g., quetiapine) “off indication” in the elderly as the increased absolute risk is substantial (number needed to harm = 185). |
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Permanent link to this article: https://evidencebasedmedicine.com.au/?p=191
Journal reference: Eick AA, Uyeki TM, Klimov A, et al. Maternal influenza vaccination and effect on influenza virus infection in young infants. Arch Pediatr Adolesc Med. 2010;0(2010):archpediatrics.2010.192 [1]
Link: http://dx.doi.org/10.1001/archpediatrics.2010.192
Published: 4 October 2010
Evidence cookie says... |
Maternal influenza vaccination during pregnancy has a limited effect on infant influenza-like illness (ILI).
- it was not associated with a change in the incidence of medically attended ILI in infants up to 6-months of age;
- however, it was associated with a ↓ 39% risk of hospital admissions for ILI
Australian guidelines already recommend influenza vaccination in pregnancy [2].
Note: this study has significant limitations, please see below for details. |
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Permanent link to this article: https://evidencebasedmedicine.com.au/?p=542
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