Liquid-based cytology is a commonly used method for cervical cancer screening, but new evidence suggests that ThinPrep, a liquid-based test, is no more effective than conventional cytology.
Level 2: Mid-level evidenceIn two recent randomized trials, prostate cancer screening did not appear to show clinically significant benefits. The large European Randomized Study of Screening for Prostate Cancer (ERSPC) evaluated prostate-specific antigen (PSA) testing in 182,000 men with median follow-up of nine years (N Engl J Med. 2009;360:1320-1328; available at content.nejm.org/cgi/content/full/360/13/1320, accessed May 12,…
Level 1: Likely reliable evidence In 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…
Although providers may strive to practice good medicine, uphold their personal limits, and offer the highest standard of care, many of will still be named in a malpractice suit.
Number of medical malpractice cases has plunged in Pennsylvania since the state changed two procedures.
Nevada has overhauled the state medical board’s discipline procedures in an effort to make them more responsive to dangerous practices and more open to public scrutiny.
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…
When obtaining a social history, ask “How much do you drink?” rather than “Do you drink?” This question is less judgmental and more likely to get a truthful answer. The response can be most revealing (especially if the patient is an adolescent or young adult).—APRIL SCRUGGS, MSN, FNP-C, Evington, Va. (128-16)
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…
Since Dr. Spak believes we should treat non-group A strep and I do not (Items 114-25 and 115-26), I would like to see conclusive evidence-based data that “treatment is definitely indicated” in patients with significant clinical complaints and positive testing for non-group A strep. A number of references, including some from the Infectious Diseases Society…
