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

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

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

ACETAMINOPHEN AND HYOSCINE BUTYLBROMIDE EACH MAY IMPROVE CRAMPY ABDOMINAL PAIN

Level 2: Mid-level evidence The efficacy of acetaminophen (Tylenol and others) and hyoscine butylbromide alone and in combination was evaluated in a study of 1,935 patients aged 18-70 years who had recurrent crampy abdominal pain for at least two months (Aliment Pharmacol Ther. 2006;23:1741-1748). The single-blind trial had a one-week placebo run-in period; bowel habits…

EARLY AMBULATION FOR DVT APPEARS SAFE AND MAY BE BENEFICIAL

Level 2: Mid-level evidence Early mobilization was associated with a lower incidence of deep venous thrombosis (DVT) progression in a randomized trial of 103 patients hospitalized for proximal DVT, but the results did not reach statistical significance (Curr Med Res Opin. 2006;22:593-602). Patients were randomized to five days of strict bed rest vs. early mobilization;…

INSPIRATORY MUSCLE TRAINING REDUCES PULMONARY COMPLICATIONS IN HIGH-RISK CABG PATIENTS

Level 1: Likely reliable evidence Preoperative inspiratory muscle training prevented pneumonia in a randomized trial of 279 patients undergoing coronary artery bypass graft (CABG) surgery who were at high risk for pulmonary complications (JAMA. 2006;296:1851-1857). High risk was defined as forced expiratory volume in one second (FEV1) <80% predicted and ratio of FEV1 to forced…

CAREGIVER SUPPORT DELAYS NURSING-HOME PLACEMENT FOR PATIENTS WITH ALZHEIMER’S DISEASE

Level 2: Mid-level evidence Caregiver support was evaluated in a randomized trial of 406 spouse-caregivers of community-dwelling patients with Alzheimer’s disease (AD) (Neurology. 2006;67:1592-1599). Caregivers were randomized to enhanced counseling and support intervention vs. usual care until the caregiver became too ill to participate or two years after the patient died. Caregivers had to be…

AMOXICILLIN TREATMENT FOR THREE DAYS vs. EIGHT DAYS

Level 2: Mid-level evidence A recent trial involved 121 adults hospitalized for community-acquired pneumonia who were improved after three days of IV amoxicillin (BMJ. 2006;332:1355; full-text available online without charge at: http://bmj.bmjjournals.com, accessed February 7, 2007). Following completion of the IV amoxicillin, patients were randomized to oral amoxicillin 750 mg three times daily for five…

EXTRACORPOREAL SHOCK WAVE THERAPY APPEARS INEFFECTIVE FOR LATERAL ELBOW PAIN

Level 2: Mid-level evidence Extracorporeal shock wave therapy (ESWT) for treatment of lateral elbow pain (tennis elbow) seemed ineffective in a Cochrane review, but the evidence is conflicting (Cochrane Database Syst Rev. 2005;[4]:CD003524). Nine randomized, placebo-controlled trials (involving 1,006 patients) and one comparison trial with steroid injections in 93 patients were systematically reviewed. Five of…

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