Print Issue: February 09, 2007

INHALED STEROIDS MAY BE BENEFICIAL IN MODERATE-TO-SEVERE COPD

Level 2: Mid-level evidence The efficacy of inhaled corticosteroids for treating moderate-to-severe chronic obstructive pulmonary disease (COPD) was evaluated in a systematic review of 13 randomized placebo-controlled trials (Ann Fam Med. 2006;4:253-262; full-text available online free of charge at www.annfammed.org/cgi/content/full/4/3/253. Accessed January 9, 2007). Trial participants were outpatients who were followed for at least six…

WET WOUND MANAGEMENT 12-48 HOURS AFTER SURGERY DOES NOT APPEAR TO INCREASE RISK OF INFECTIONS

Level 2: Mid-level evidence In a study of 870 patients who had minor skin excisions and were randomized to wet vs. dry wound management, allowing sutures to get wet 12-48 hours following surgery did not increase the risk of infection (BMJ. 2006;332:1053-1056; full-text available online free of charge at www.bmj.com/cgi/content/full/332/7549/1053. Accessed January 9, 2007). The…

TEGASEROD EFFECTIVE FOR WOMEN WITH CONSTIPATION-PREDOMINANT IBS

Level 1: Likely reliable evidence A randomized, placebo-controlled trial of 2,660 women found that tegaserod (Zelnorm) was effective for initial treatment and during recurrence of irritable bowel syndrome (IBS) flares (Gut. 2005;54:1707-1713). The women, who had constipation-predominant IBS, were randomized to receive oral tegaserod 6 mg twice daily vs. placebo for one month. Symptom relief…

ANTISEPTIC TREATMENT OF UMBILICAL CORD REDUCES OMPHALITIS…

Level 1: Likely reliable evidence … AND MAY REDUCE MORTALITY IN DEVELOPING COUNTRIES Level 2: Mid-level evidence A previous systematic review found no evidence that doing nothing but keeping the umbilical stump clean was harmful to the infant (Cochrane Database Syst Rev. 2004;[3]:CD001057). No systemic infections or deaths were observed in the 21 randomized and…

SUBLINGUAL IMMUNOTHERAPY RELIEVES ALLERGIC RHINITIS

Level 1: Likely reliable evidence Immunotherapy may be effective in patients with persistent allergic rhinitis symptoms who have failed other treatments. Therapy is generally provided in the form of “allergy shots” given subcutaneously according to a schedule (often weekly) of carefully titrated antigen doses. The injections may be discontinued after four to five years because…

CAROTID ENDARTERECTOMY MAY REDUCE RISK OF STROKE COMPARED WITH CAROTID ARTERY STENTING

Level 2: Mid-level evidence Stenting may be an alternative to open endarterectomy for the treatment of carotid artery stenosis. The Endarterectomy versus Angioplasty in Patients with Symptomatic Severe Carotid Stenosis (EVA-3S) trial compared these two procedures in 527 adults with hemispheric or retinal transient ischemic attack or nondisabling stroke within 120 days and carotid artery…

DUCT TAPE MAY BE MODESTLY EFFECTIVE TREATMENT FOR WARTS ON THE HAND

Level 2: Mid-level evidence Duct tape for warts was studied in a randomized, “placebo”-controlled trial (Arch Pediatr Adolesc Med. 2006;160:1121-1125). Children aged 4-12 years with warts (N=103) were randomized to have a single wart treated with duct tape vs. corn pad for six weeks. After seven days of application, the duct tape was removed and…

More than a drug is required for insomnia

Persistent sleeplessness stems from a variety of factors, all of which should be addressed if a treatment plan is to succeed long-term. While many patients (10%-40% of the population) complain about insomnia, few actually seek help. In a recent survey, almost 30% of respondents complained about symptoms of insomnia, yet only 13% discussed them with…

How to control BP

The elderly are different when it comes to managing blood pressure. A physician spells out the differences and tells how to handle them. Hypertension is almost inevitable as we age. The famous Framingham Heart Study suggests that those who are normotensive at age 55 face a 90% lifetime risk for developing high BP.1 This is…

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