Alan Ehrlich, MD, Author at Clinical Advisor

Alan Ehrlich, MD

All articles by Alan Ehrlich, MD

PCI with paclitaxel-eluting stent might be alternative to CABG

Level 1: Likely reliable evidenceIn patients with three-vessel and/or left main coronary artery disease (CAD), percutaneous coronary intervention (PCI) with paclitaxel-eluting stents is equivalent to coronary artery bypass grafting (CABG) for overall mortality and MI rate at 12 months. PCI patients had increased risk for repeat revascularization procedures but a reduced risk of subsequent stroke…

Dronedarone may reduce both hospitalization and cardiovascular mortality in AF patients

Level 2: Mid-level evidenceRhythm control strategies for atrial fibrillation (AF) have not been shown to be generally more beneficial compared with rate control. Most patients with rhythm control will have some amount of intermittent AF that necessitates anticoagulation. The principal benefit is for patients who cannot tolerate the symptoms of AF.  A recent randomized trial…

Laparoscopic hernia repair in children increases pain and surgery time

Level 1: Likely reliable evidenceA randomized trial compared laparoscopic and open surgery in 90 children aged 4 months to 16 years with unilateral inguinal hernia (Pediatrics. 2009;123:332-337). Laparoscopic repair was associated with longer times in the operating room (63 vs. 38 minutes, P <.001) and day surgery ward (300 vs. 230 minutes, P <.001) and…

Routine immediate imaging may yield no benefit for acute low back pain

Level 2: Mid-level evidenceAlthough lumbar imaging for acute low back pain is generally indicated only if there is concern for serious underlying disease (e.g., infection, malignancy), many physicians continue to order imaging studies on a routine basis for these patients. In support of previous research, a recent systematic review of six randomized trials evaluating immediate…

Antipsychotic meds associated with reduced survival in patients with Alzheimer’s disease

Level 2: Mid-level evidenceIn April 2008, the Dementia Antipsychotic Withdrawal Trial (DART-AD) showed that stopping antipsychotic treatment did not worsen cognitive, functional, or behavioral status in most elderly patients with Alzheimer’s disease (PLoS Med. 2008;5:e76; accessed April 8, 2009). Based on results of short-term trials that indicated an increased mortality risk, the FDA has previously…

Midwife-led care recommended as an option for pregnant women

Level 1: Likely reliable evidence A recent Cochrane review of 11 randomized trials involving 12,276 pregnant women has recommended midwife-led care as a safe and effective option for childbirth (Cochrane Database Syst Rev. 2008;[4]:CD004667; accessed April 8, 2009). Compared with other models, midwife-led care was associated with significantly lower rates of antenatal hospitalization, instrument birth,…

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