EE+ POEM Archive
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- 1 week = 2 week treatment for HP eradication
- 3 clinical features distinguish PID from appendicitis
- 7 days of tx good for H. pylori
- A PPI test does not improve diagnosis of GERD
- ABCD rule predicts 7- and 30-day stroke risk in pts with TIA
- ABCD score predicts 7 day stroke risk in patients with TIA
- Abnormal nuchal translucency does not = abnormal child
- ACC/AHA: Fewer patients require prophylaxis for endocarditis
- ACE = ARB for secondary CV prevention; combination worse (ONTARGET)
- ACE = ARB, but ACE + ARB worsens renal outcomes (ONTARGET)
- ACE inhibitors effective in CAD without CHF
- ACS risk similar with normal ECG performed during presence or absence of chest pain
- Acupuncture may have value in treating GERD
- Acupuncture possibly effective for ulcerative colitis
- Aggressive early tx after TIA/minor stroke improves outcomes (EXPRESS)
- Alexander technique reduces low back pain disability
- Aloe vera not effective for irritable bowel syndrome
- Alpha-blocker or nifedipine may help pass kidney stones
- Amitriptyline effect on QOL in teens with IBS is equivocal
- Anticholinergics, pelvic floor muscle exercises improve urinary incontinence in women
- Antioxidants don't prevent colorectal cancer
- Antiplatelet agents prevent preeclampsia
- Apolipoprotein levels no better than standard methods to evaluate CVD risk
- ARB treatment of high CV risk patients
- ARBs reduce BP in prehypertensive patients
- ASA effective in secondary prevention of vascular disease, uncertain in primary prevention
- ASA+dipyridamole better than ASA for cerebral ischemia (ESPRIT)
- Aspirin + dipyridamole = clopidogrel for recurrent stroke prevention (PROFESS)
- Aspirin = enoxaparin for prevention of recurrent miscarriage
- Aspirin dose >81mg daily not beneficial for secondary prevention of CVD
- Aspirin prevents colon cancer
- Aspirin prevents vascular events in patients with PAD
- Atkins equally or more effective for weight loss in premenopausal women
- Atrial fibrillation recurrence higher with episodic treatment with amiodarone
- Bariatric surgery reduces all-cause mortality in morbidly obese
- Benign course for symptomatic uncomplicated diverticular disease
- Blatchford score more sensitive than Rockall in GI bleeding
- Bleeding risk with warfarin high among elderly, especially older than 80
- Blunt abdominal trauma score predicts absence of organ injury in kids
- BMI poor predictor of mortality in patients with CAD
- Botulinum might be more effective than nitroglycerine in anal fissure
- Botulinum toxin effective for excessive drooling
- BP and cholesterol are associated with vascular mortality
- BP lowering by any means is beneficial in most
- Capsule endoscopy more sensitive than push enteroscopy
- Cardiac resynchronization therapy effective for NYHA class 3 and 4 heart failure
- Carotid bruits are associated with AMI and CV death
- Carotid stent inferior to carotid endarterectomy
- Carvedilol decreases mortality, slightly improves QOL in HF (COMET)
- Carvedilol not beneficial for children and adolescents with heart failure
- Catheter ablation of AF prevents recurrence but has minimal impact on QOL
- Celiac disease common in primary care patients with chronic GI symptoms
- Chewing gum hastens bowel motility and shortens hospital stay after colorectal surgery
- Cholesterol lowering benefits patients at risk for CHD
- Cholesterol lowering cost-effective in high-risk elderly
- Citalopram of modest benefit for IBS
- Clopidogrel + ASA for afib: fewer strokes, more hemorrhages (ACTIVE)
- Clopidogrel + ASA no better than ASA alone for high-risk patients
- Coffee does not increase risk of developing CAD
- Cognitive functioning improved by correcting anemia in young women
- Colon CA unlikely if unexplained anemia but ferritin >100 ng/mL
- Colon cancer screening may be beneficial for Lynch syndrome
- Colonoscopy interval of at least 5 years is safe
- Continued BP control important in T2DM (UKPDS)
- Coumadin + aspirin no better than aspirin alone for PAD
- CPAP and NIPPV no better than O2 in acute pulmonary edema (3CPO)
- CPAP associated with decreased CV risk
- CT colonography detects 85% of large polyps in patients at increased risk of colon cancer
- CT colonography detects 90% of large polyps under optimal conditions
- CT colonography less accurate with small polyps
- CT colonography similar to colonoscopy at detecting advanced lesions
- CV interventions in old elderly are not useful (DEBATE)
- D-dimer can identify high-risk group for extended anticoagulation (PROLONG)
- Diet and exercise prevent diabetes
- Diet, exercise, drugs may prevent diabetes in high-risk patients
- Different SSRIs associated with specific birth defects; fluoxetine safest
- Don't add aspirin to warfarin therapy except with mechanical heart valve
- Door-to-balloon time important in STEMI
- Dressing choice unimportant for leg ulcers
- Dronedarone prevents AF recurrence but effect on symptoms unknown
- Early angiography not crucial in low risk NSTEMI patients (TIMACS)
- Early endoscopy not needed in GERD without alarm symptoms
- Early initiation of statins following ACS does not improve outcomes
- Early invasive therapy better for non-ST ACS
- EE + POEM Archive
- Effective methods for preventing pressure ulcers
- Elective cesarean does not preserve anal continence
- Emergency department management decreases A Fib admissions
- Enoxaparin > UFH for STEMI treated with fibrinolysis then PCI
- Enoxaparin > UFH for STEMI, with or without clopidogrel
- Escitalopram (Lexapro) reduces risk of poststroke depression
- Esomeprazole doesn't improve asthma symptoms
- Esophageal cancer occurs in 7/1000 per year
- Excess enoxaparin increases adverse outcomes in non-ST elevation ACS
- Excessive lowering of BP causes more harm than good
- Ezetimibe does not slow progression of coronary disease (ENHANCE)
- Fecal DNA testing = Hemoccult Sensa for colon cancer screening
- Fecal immunochemical testing more sensitive than guaiac testing
- Fenofibrate reduces laser photocoagulation (FIELD)
- Fibromyalgia treatment guidelines from EULAR
- First-degree AV block associated with increased risk of adverse outcomes
- Fixed-dose, subcutaneous, unfractionated heparin effective for VTE
- Folate prevents stroke
- Folic acid does not reduce risk of colorectal adenomas
- Folic acid supplementation does not reduce CVD risk nor mortality
- For severe secondary peritonitis, on-demand relaparotomy > planned relaparotomy
- Furosemide doesn't prevent acute renal failure
- Gallbladder disease less common with transdermal ERT
- GERD tx in children assoc with pneumonia risk
- Glitazones may be beneficial post-PCI
- Greater sustained weight loss with gastric bypass than banding
- Guidelines for managing VTE (AAFP, ACP)
- Guidelines for the clinical diagnosis of VTE (AAFP, ACP)
- H. pylori tx effective in long-term PPI users
- Hand washing programs prevent GI and respiratory infections
- Harms outweigh benefits of aspirin/NSAID for colon cancer prevention
- Helium-oxygen improves exercise tolerance in pts with COPD
- Hep A vaccine similar to immune globulin for postexposure prophylaxis
- High volume of AAA repairs associated with lower mortality
- High-dose atorvastatin reduces recurrent stroke, not mortality (SPARCL)
- Homocysteine lowering not helpful in women at high risk for CVD
- Hypertension treatment effective even after age 80
- Hypnotherapy effective for noncardiac, non-GERD chest pain
- Idraparinux effective for DVT but not for PE
- Immediate transfer for angioplasty after fibrinolysis beneficial for STEMI (TRANSFER-AMI)
- In ACS, 5 yrs of invasive tx decreases MI but not all cause mortality (FRISC-II)
- Incidental findings common on brain MRI in adults
- Increased risk of CP after antibiotics for PTL
- Inhaled anticholinergics associated with increased risk of CVD in COPD
- Intensive lipid lowering adds additional benefit
- Intensive lipid lowering reduces mortality following ACS
- Interpreting BNP in patients with a history of HF
- Invasive strategy best only for men and high-risk women with unstable angina/non-ST elevation MI
- IV iloprost may reduce healing time for venous ulcers
- Lab-based = non-lab-based models for CVD prediction
- Less bleeding with fondaparinux vs enoxaparin for ACS with PCI
- Levels of Evidence
- Little benefit to revascularization over intensive medical treatment in DM with CAD
- Little information on racial differences between antihypertensives
- LMWH = UFH for thrombocytopenia
- LMWH better than UFH for acute DVT
- LMWH better than unfractionated heparin for preventing DVT in medical patients
- Low risk of DVT after knee arthroscopy
- Lowering homocysteine with B vitamins doesn't improve cognition
- Many patients using warfarin also take aspirin
- Maternal obesity associated with neural tube defects
- MDCT safe and accurate for coronary evaluation in dilated cardiomyopathy
- Medical tx prevents variceal bleeds better
- Medications help passage of kidney stones
- Meta-analysis: BP drugs equally effective in young and old
- Metformin does not harm patients with HF and diabetes
- Migraine with aura associated with increased risk of CVD in women
- Minocycline improves stroke outcomes
- Moderate coffee consumption safe after AMI
- Modified TIMI score improves CV event prediction
- Mortality from in-hospital cardiac arrest highest during nights and weekends
- Most endocarditis prophylaxis no longer necessary: NICE guideline
- Multidetector CT accurate for PE, but requires clinical context
- Multifactorial intervention improves outcomes in T2DM (Steno-2)
- Multislice CT is safe and efficient for evaluation of low-risk chest pain
- Nesiritide provides no additional benefit in the emergency department
- New biomarkers add little to current predictors for CAD
- NICE guidelines for diabetes mellitus, type 2
- NICE guidelines for lipid lowering
- Nonfocal transient neurological attacks increase risk of future stroke and dementia
- Noninvasive carotid imaging can replace invasive imaging
- NT-BNP reduces cost and rehospitalization rates in dyspneic patients.
- O2 not helpful in overall QOL in COPD with exertional hypoxia
- Omega-3 fatty acids have small analgesic effect
- Omega-3 FFAs not effective for relapse prevention in Crohn disease
- Once-weekly tai chi decreases rate of falls in the elderly
- Ondansetron effective for gastroenteritis with vomiting
- Optimal algorithm for evaluating suspected DVT
- Optimal dosing for thromboprophylaxis in medical inpatients
- Optimal medical tx = PCI + optimal medical tx for stable CAD
- PA-led rapid response team beneficial
- Patent foramen ovale not necessarily associated with stroke recurrence
- PCI better than drug therapy for postinfarction silent ischemia
- PCI not useful for occluded vessel after completed STEMI
- PCI provides short-term quality of life improvement in stable angina (COURAGE)
- Pedigree identifies hereditary breast cancer syndromes
- Pedometer use increases physical activity and may promote weight loss
- Pedometer-based programs result in modest weight loss
- Pergolide, cabergoline increase risk of heart valve damage
- Perinatal steroids not associated with adverse CV function 7-10 years later
- Perindopril+indapamide improves outcomes in high-risk pts with DM (ADVANCE)
- Perioperative metoprolol: fewer CV events and MIs, more deaths and strokes (POISE)
- Pharmacist-assisted Web-based care improves hypertension control
- Phlebotomy decreased cancer risk in patients with PAD
- Pioglitazone does not increase cardiovascular events (PROactive)
- PPI use reduces benefit of clopidogrel post-MI
- Presence of risk factors doesn't predict acute coronary syndrome
- Prognosis of bicuspid aortic valve depends on age, severity of valve dysfunction
- Pulmonary Embolism (PE) Severity Index predicts low risk PE patients.
- QI measures increased evidence based therapies and reduced LOS for HF patients
- Raloxifene decreases breast CA risk, no effect on CVD risk (RUTH)
- Ranolazine (Ranexa) not effective for ACS
- Ranolazine adds little to maximum antianginal therapy (ERICA)
- Red hot chili peppers do not worsen hemorrhoid symptoms
- Reducing homocysteine not beneficial in advanced chronic kidney disease
- Reducing iron stores does not benefit patients with peripheral arterial disease
- Repair undescended testis before age 13
- Repolarization abnormality in athletes is risk factor for cardiomyopathy
- Rhythm control improves quality of life in patients with CHF and AF
- Rhythm control no better than rate control in AF + CHF
- Rofecoxib, diclofenac and indomethacin increase risk of CVD
- Rosiglitazone associated with increased risk of acute MI
- Rosiglitazone delays developing DM (DREAM)
- Rosuvastatin does not improve outcomes in HF with average lipids
- Rosuvastatin has no effect on clinical outcomes in CHF
- Same-day discharge after PCI is safe
- Screening for carotid artery stenosis not helpful, may be harmful (USPSTF)
- Sentinel node biopsy = less lymphedema, better QOL (ALMANAC)
- Serial proximal vein ultrasonography + D-dimer = whole-leg Doppler for suspected leg DVT
- Signs and symptoms not helpful in diagnosis of AMI/ACS
- Sirolimus stents decrease long-term restenosis (RAVEL)
- Smaller benefit of statins without heart disease
- Some older patients benefit from statin therapy
- Specialized training decreases injuries in elite athletes
- Statin use may reduce risk of cataracts
- Tibolone prevents osteoporotic fracture, increases stroke risk (LIFT)
- Tight glycemic control may decrease CV end points in patients with type 2 DM
- Tolvaptan does not improve long-term HF outcomes
- Treating prediabetes does not affect progression
- Troponin predicts adverse outcome in HF (ADHERE)
- Typical hand gestures not useful for chest pain diagnosis
- TZDs increase CHF events in pts with DM or with prediabetes
- Uncertain benefit of aspirin for peripheral artery disease
- Uncertain role of testing for genetic mutations in adults with VTE or in at-risk family
- Uncertain value of automated chest compression device for cardiac arrest
- Under ideal conditions thrombolysis may be helpful within 3 to 4.5 hours
- USPSTF recommends screening for diabetes in hypertensive patients
- Vasodilators of little use with aortic insufficiency
- Vasopressin, steroids, and epinephrine improve in-hospital cardiac arrest survival
- Vitamin K supplementation improves stability of anticoagulation
- VTE: Up to 10% with unexplained embolus will have cancer
- Warfarin > aspirin in preventing strokes in pts older than 75 with A fib (BAFTA)
- Warfarin can safely be held for the short term
- Warfarin prevents more strokes than clopidorel+ASA in a fib (ACTIVE)
- Warfarin superior to antiplatelet treatment for A Fib
- Warfarin: damned if you do, damned if you don't
- Work stress has no meaningful effect on BP