News You Can Use

Vaccines for travelers

by jmiller on December 5, 2014

The Medical Letter on Drugs and Therapeutics devotes its entire November 24th issue to vaccines for travelers.  Click here to read full text.

Consensus Guideline: ACR appropriateness criteria definitive external-beam irradiation in Stage T1 and T2 prostate cancer

by jmiller on December 5, 2014

“External-beam radiation is a key component of the curative management of T1 and T2 prostate cancer.  By combining the most recent medical literature and expert opinion, this guideline can aid physicians in the appropriate use of external-beam radiation for prostate cancer.  The outcome for patients with localized prostate cancer depends on the aggressiveness of their disease, their natural life expectancy, and the efficacy and toxicity of the chosen therapy.  In retrospective series, definitive EBRT for the treatment of stage T1 and T2 prostate cancer seems to be as effective as other treatments modalities.  (e.g. radical prostatectomy and brachytherapy).  (Am J Clin Oncol, June)  Click here to read full-text.

Diagnosis of obstructive sleep apnea in adults: A clinical practice guideline from the American College of Physicians

by jmiller on December 5, 2014

This clinical practice guideline recommends 1:  a sleep study for patients with unexplained daytime sleepiness, and 2:  polysomnography for diagnostic testing in patients suspected of obstructive sleep apnea.  ACP recommends portable sleep monitors in patients without serious comorbidities as an alternative to polysomnography when polysomnography is not available for diagnostic testing.   (Ann Intern Med, Aug 5)  Click here to read full text.

Nonsurgical management of urinary incontinence in women: A clinical practice guideline from the American College of Physicians

by jmiller on December 5, 2014

This practice guideline provides six recommendations for the nonsurgical management of urinary incontinence.  “Urinary incontinence is a common and important health care problem in women that is underrported and underdiagnosed.  Clinicians should use nonpharmacologic management for UI, such as pelvic floor muscle training (PFMT) for stress jurinary incontinence, bladder training for mixed urinary incontinence, because these therapies are effective, have few adverse effects, and are cheaper than pharmacolgic therapies.  Although pharmacologic therapy can improve UI and provide complete continence, many patients discontinue medication because of adverse effects. (Ann Intern Med, Sept)   Click here to read full text.

Clinical practice guidelines for the management of pain, agitation and delirium in adult patients in the ICU

by jmiller on December 5, 2014

These guidelines provide a roadmap for developing integrated, evidence-based, and patient-centered protocols for preventing and treating pain, agitation, and delirium in critically ill patients.(Crit Care Med, Jan 2013) Click here to view full-text.

CDC Ebola Guidelines, Fact Sheet, and Triage Algorithm

by jmiller on October 24, 2014

Click here to read full-text on the CDC Guidelines regarding Ebola, including PPE donning and doffing.

ACCF and AHA release guidelines on the management of heart failure

by jmiller on October 23, 2014

These Practice Guidelines (Am Fam Phys, Aug) make the following key points:  Treatment of stage A heart failure should focus on reducing modifiable risk factors, including management of hypertension and hyperlipidemia; To prevent symptomatic heart failure, ACE inhibitors and beta blockers hould be used in all patients with stage B or C heart failure who have a reduced ejection fraction; Patients with stage C heart failure and fluid retention should be treated with diuretics in addition to ACE inhibitors and beta blockers.  Click here to read full text.

Ebola virus disease in West Africa – the first 9 months of the epidemic and forward projections

by jmiller on October 3, 2014

This Sept. “in press” article, (NEJM) concludes “these data indicate that without drastic improvements in control measures, the numbers of cases of and deaths from ebola virus disease are expected to continue increasing from hundreds to thousands per week in the coming months.”  Click here to read full-text.

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