Brian S. Alper, MD, MSPH, and Cynthia Brown, MD, Author at Clinical Advisor - Page 2 of 8

Brian S. Alper, MD, MSPH, and Cynthia Brown, MD

All articles by Brian S. Alper, MD, MSPH, and Cynthia Brown, MD

IV ceftriaxone no more effective than oral doxycycline for mild Lyme neuroborreliosis

Level 2: Mid-level evidenceThe efficacy of oral doxycycline was compared with that of IV ceftriaxone (Rocephin) in a randomized trial of 118 patients with Lyme neuroborreliosis (Lancet Neurol. 2008;7:690-695). Patients were randomized to oral doxycycline 200 mg plus IV placebo vs. IV ceftriaxone 2 g plus oral placebo once daily for 14 days. Analysis based…

Rosuvastatin lowers mortality and cardiovascular events in patients with high CRP, normal cholesterol

Level 1: Likely reliable evidenceThe Justification for the Use of Statins in Primary Prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER) studied the use of rosuvastatin (Crestor) for prevention of cardiovascular events in patients with normal cholesterol levels but elevated C-reactive protein (CRP) levels (N Engl J Med. 2008;359:2195-2207). A total of 17,802 patients (11,001 men…

St. John’s wort may be as effective as standard antidepressants — and more tolerable — for major depression

Level 1: Likely reliable evidenceA recent Cochrane systematic review evaluated the efficacy and safety of St. John’s wort extracts for the treatment of major depression (Cochrane Database Syst Rev. 2008[4]:CD000448). The review included 29 randomized trials comparing St. John’s wort with placebo (11 trials), standard antidepressants (12 trials), or both (six trials) in a total…

Incidence of cervical intraepithelial neoplasia was lower in those who tested negative for HPV DNA.

Negative HPV DNA testing may predict very low risk of CIN grade 3 or cancer

Level 2: Mid-level evidenceA multinational cohort study evaluated 24,295 women who had cervical cytology and HPV screening at baseline and one or more cervical cytology or histopathology exams within the five- to six-year follow-up period (BMJ. 2008;337:a1754). Follow-up was completed by 20%-31% of women, which may weaken the predictive value of negative HPV DNA results.…

Covering of head during sleep associated with increased risk of SIDS

Level 2: Mid-level evidenceCovering of the head during sleep was associated with an increased risk of sudden infant death syndrome (SIDS), based on a systematic review of 10 case-control studies with data on prevalence of head covering during sleep in 1,234 cases and 3,822 controls (Arch Dis Child. 2008;93:778-783). All studies distinguished covering of the…

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