Supplemental Updates: Review of Natural Products and ACP Journal Club

 

 

Review of Natural Products

©2009 by Facts and Comparisons, A Wolters Kluwer Company

Authors/Editors: Ara DerMarderosian, PhD & John A. Beutler, PhD

As natural products continue to rise in popularity, there is an increased need for unbiased, accurate, scientifically based information on these products. The Review of Natural Products, already well established and highly regarded as a publication to meet this need, has been revised significantly to prove even more useful to health care professionals. Clinical information has been added and highlighted in all of the monographs so users can find critical information quickly.

The editors, contributing editors, and advisory panel have extensive experience in the field of natural product pharmacy and medicine. The Review of Natural Products includes more than 300 monographs and is updated monthly. Each monograph features scientific names, common names, botan or source, history, chemistry, uses and pharmacology, dosing, pregnancy/lactation, interactions, adverse reactions, toxicology, and references. A "Clinical Overview" box at the beginning of each monograph summarizes the use, dosing, contraindication, pregnancy/lactation, interaction, adverse reaction, and toxicology information.

What's New in January 2010:

NEW MONOGRAPHS

ARNICA

Scientific Name(s): Arnica montana L. In addition, other related species have been used medicinally including Arnica sororia Greene, Arnica fulgens Pursh., Arnica cordifolia Hook., Arnica chamissonis subsp. foliosa (Nutt.) Maguire. Family: Asteraceae (daisies)

Common Name(s): Arnica flos, Leopard's bane, mountain snuff, mountain tobacco, sneezewort

Uses: Arnica and its extracts have been widely used in folk and homeopathic medicine as a treatment for acne, boils, bruises, rashes, sprains, pains, and other wounds. Overall, there does not appear to be sufficient evidence to support the use of arnica as an anti-inflammatory or analgesic agent, or to prevent bruising; however, heterogeneity of doses and delivery forms (as well as indications) in available clinical studies makes generalizations difficult.

ASPARAGUS

Scientific Name(s): Asparagus officinalis L. Family: Liliaceae

Common Name(s): Asparagus-P, garden asparagus

Uses: Asparagus stalks are commonly eaten as a vegetable. Roots, seeds, and extracts have been used as a treatment for various illnesses and as a diuretic, despite the lack of clinical evidence. Other species, such as Asparagus racemosus, are used in traditional Chinese and Ayurvedic medicine systems.

LENTINAN

Scientific Name(s): Lentinula edodes (Berk.) Pegler. Family: Tricholomataceae

Common Name(s): Shiitake, snake butter, pasania fungus, forest mushroom, hua gu . (Also found in Selected Vegetables and Sun's Soup, which are promoted for cancer and HIV therapy.) Synonyms include Cortinellus edodes, Armillaria edodes, Cortinellus shiitake, and Tricholomopsis edodes .

Uses: Lentinan is used widely in Japan and China as an adjuvant to cancer chemotherapy. It is also used for upregulating the immune system; however, the number of quality clinical trials and studies published in English language, peer-reviewed journals is limited.

SAFFRON

Scientific Name(s): Crocus sativus L. Family: Iridaceae

Common Name(s): Saffron, za'faran

Uses: Saffron has widespread traditional uses. It has demonstrated efficacy in mild to moderate depression; however, a limited number of quality clinical trials exist. Potential exists for a role in the treatment of cancer and age-related macular degeneration.

 

ACP Journal Club

©2009 by the American College of Physicians

Authors/Editors: Brian Haynes, MD, PhD

 ACP Journal Club, published by the American College of Physicians, is the quintessential EBM journal, and is often positioned near the top of the EBM pyramid.

The combination of ACP Journal Club and PIER provides us with the potential to deliver an EBM product that is superior to competitive offerings. ACP Journal Club is published 6 times per year.

Purpose of ACP Journal Club: "ACP Journal Club's general purpose is to select from the biomedical literature articles that report original studies and systematic reviews that warrant immediate attention by physicians attempting to keep pace with important advances in internal medicine. These articles are summarized in value-added abstracts and commented on by clinical experts."

What's New: December 2009 - Volume 151, Number 6

Therapeutics

Ticagrelor was more effective than clopidogrel, with no increase in major bleeding in acute coronary syndromes

A Mediterranean-style diet reduced need for glucose-lowering drugs more than a low-fat diet in type 2 diabetes

Human papillomavirus 16/18 AS04-adjuvanted vaccine prevented cervical intraepithelial neoplasia in young women

Review: Pregabalin reduces chronic neuropathic pain in adults

Vertebroplasty was not effective for painful osteoporotic vertebral fractures

PET plus CT was better than conventional methods for correctly upstaging early NSCLC

Screening with spiral CT did not reduce lung cancer mortality in older male smokers

Diagnosis

Sensitive cardiac troponin assays were more accurate than a standard troponin assay for early diagnosis of AMI

Etiology

Anemia was independently associated with mortality in very old persons

Continuous androgen-deprivation therapy increased risk for diabetes and fragility fractures in older men with prostate cancer

SSRIs in early pregnancy were associated with increased risk for septal heart defects but not major congenital malformations overall

STAT!Ref Supplemental Updates: Review of Natural Products and ACP Journal Club

 

 

Review of Natural Products

©2009 by Facts and Comparisons, A Wolters Kluwer Company

Authors/Editors: Ara DerMarderosian, PhD & John A. Beutler, PhD

As natural products continue to rise in popularity, there is an increased need for unbiased, accurate, scientifically based information on these products. The Review of Natural Products, already well established and highly regarded as a publication to meet this need, has been revised significantly to prove even more useful to health care professionals. Clinical information has been added and highlighted in all of the monographs so users can find critical information quickly.

The editors, contributing editors, and advisory panel have extensive experience in the field of natural product pharmacy and medicine. The Review of Natural Products includes more than 300 monographs and is updated monthly. Each monograph features scientific names, common names, botan or source, history, chemistry, uses and pharmacology, dosing, pregnancy/lactation, interactions, adverse reactions, toxicology, and references. A "Clinical Overview" box at the beginning of each monograph summarizes the use, dosing, contraindication, pregnancy/lactation, interaction, adverse reaction, and toxicology information.

What's New in December 2009:

NEW MONOGRAPHS:

POTATO

Scientific Name(s): Solanum tuberosum L. Family: Solanaceae (nightshade) Common Name(s): Potato, Irish potato, white potato, US russet Uses: Potatoes are rich in starch and may affect glycemic control and insulin levels in people with diabetes. Antioxidant effects and protease inhibitor action are being studied.

METHYLSULFONYLMETHANE (MSM)

Scientific Name(s): Methylsulfonylmethane, DMSO2 Common Name(s): MSM Uses: MSM is commonly used for osteoarthritis, but may also benefit in alleviating GI upset, musculoskeletal pain, and allergies; boosting the immune system; and fighting antimicrobial infection. Clinical trials are needed to verify these potential uses.

YOHIMBE

Scientific Name(s): Pausinystalia yohimbe (K. Schum.) Pierre ex Beille. Family: Rubiaceae. Common Name(s): Aphrodien, Aphrodyne, johimbi, Yocon, yohimbe, yohimbehe, yohimbine . Uses: Yohimbine has been used primarily in the treatment of sexual dysfunction, weight (body fat) loss, and xerostomia (dry mouth). It has also been used in studies investigating autonomic failure and orthostatic hypotension.

ACP Journal Club

©2009 by the American College of Physicians

Authors/Editors: Brian Haynes, MD, PhD

 ACP Journal Club, published by the American College of Physicians, is the quintessential EBM journal, and is often positioned near the top of the EBM pyramid.

The combination of ACP Journal Club and PIER provides us with the potential to deliver an EBM product that is superior to competitive offerings. ACP Journal Club is published 6 times per year.

Purpose of ACP Journal Club: "ACP Journal Club's general purpose is to select from the biomedical literature articles that report original studies and systematic reviews that warrant immediate attention by physicians attempting to keep pace with important advances in internal medicine. These articles are summarized in value-added abstracts and commented on by clinical experts."

What's New: November 200 - Volume 151, Number 5

Therapeutics: 

• Early transfer for angiography after fibrinolysis reduced ischemic events in patients with STEMI
• Review: Evidence for the effectiveness of vitamin D and calcium for reducing CV outcomes, cancer, and death is limited
• Review: Low BP targets do not reduce mortality or CV events in hypertension
• Tight BP control reduced left ventricular hypertrophy in nondiabetic patients with hypertension
• Preoperative staging using PET-CT reduced futile thoracotomies more than conventional staging in non-small-cell lung cancer
• Disclosure of genetic risk for Alzheimer disease did not increase anxiety or depression in asymptomatic adults
• Percutaneous closure of the left atrial appendage was noninferior to warfarin in atrial fibrillation

Diagnosis

• Capsule endoscopy had low sensitivity for detecting colonic lesions and high specificity for large lesions

Etiology

• Use of antipsychotic drugs was associated with increased risk for hyperglycemia in older patients with diabetes
• Prolonged PR intervals were associated with increased risk for atrial fibrillation, pacemaker implantation, and mortality
• Review: PPI use in pregnancy was not associated with increased congenital malformations, spontaneous abortion, or preterm delivery

Economics

• Screening for abdominal aortic aneurysm (AAA) in men 65 to 74 years of age was cost-effective for AAA mortality at 10 years

New Title, New Edition and Supplemental Updates: What's New in September 2009

New Titles:

Trauma Care: Initial Assessment and Management in the Emergency Department

©2008 Wiley-Blackwell

The often complex problems of the trauma patient present many challenges to front line emergency staff. Multiple injuries involving many systems of the body require careful and timely prioritization and intervention in the emergency department. Trauma Care provides emergency nurses with a practical guide to the systematic assessment and management of trauma patients, equipping them with the clinical knowledge and practical skills necessary to initially assess and care for the trauma patient in the emergency department trauma environment.

Atlas of Gastrointestinal Surgery, Vol. 1

2nd Edition ©2007 People's Medical Publishing House, USA

This is a beautiful, color surgical atlas, which will complete any surgeon's online library. The first edition was published 14 years ago, and this new edition reflects advances in surgical care, as well as improved illustrations and text.

The authors are authoritative leaders in surgery from the Johns Hopkins Hospital. The title describes the operative techniques on the foregut employed at this august institution. Many of the operations described were developed at Johns Hopkins. The atlas vividly depicts in color illustrations and clear language these surgical techniques, bringing them alive for the reader.

New Edition:

Ganong's Review of Medical Physiology

23rd Ed. ©2010 McGraw Hill Companies, Inc.

The field's most complete, current and engagingly written title on medical physiology -- now in full color. For more than four decades, Ganong's Review of Medical Physiology has been the leader in helping medical students and clinicians understand the fascinating subject of human and mammalian physiology. Concisely covering every important topic without sacrificing depth or readability, Ganong's delivers more detailed, clinically relevant, high-yield information per page than any similar title or review.

Supplemental Updates:

AHFS DI® Essentials™

©2009 by the American Society of Health-System Pharmacists, Inc.

AHFS DI® Essentials™ offers healthcare professionals easy access to knowledge that is critical at the point of care. Essentials™ monographs draw on the meticulously evidence-based guidelines in the full AHFS DI® database, distilling essential information on prescription and key over-the-counter (OTC) drugs in an easy-to-use and highly structured outline format.

ACP PIER, Journal Club & AHFS DI® Essentials™

©2009 by the American College of Physicians

A pre-appraised, evidence-based clinical tool that defines the standard of care, including value-added abstracts of original journal articles and drug treatment information.

•PIER (Physicians' Information and Education Resource) Integrated and authoritative EBM resources for the point-of-care and background reference.

•ACP Journal Club is the quintessential EBM journal that summarizes original research applicable to clinical cases.

•AHFS® DI Essentials™ distills the essential information from the larger AHFS Drug Information database.

ACP PIER & AHFS DI® Essentials™

©2009 ACP PIER: American College of Physicians

©2009 AHFS DI® Essentials™

PIER© is a collection of over 400 evidence summaries published by the American College of Physicians. Each module provides authoritative guidance to improve the quality of care.

ACP PIER®: Physicians' Information and Education Resource

©2009 ACP PIER: American College of Physicians

PIER© is a collection of over 400 evidence summaries published by the American College of Physicians. Each module provides authoritative guidance to improve the quality of care.

 

AHFS Drug Information®

©2009 American Society of Health-System Pharmacists

With the 2009 edition, the American Hospital Formulary Service® (AHFS™) marks over 50 years of continuous publication by the American Society of Health-System Pharmacists (ASHP). Each year, an average of over 60% of AHFS content is revised to help you provide the most accurate recommendations for your patients’ drug therapy.

 

Medical Letter® On Drugs and Therapeutics, The

©2009-1995 The Medical Letter, Inc.

The Medical Letter on Drugs and Therapeutics is an independent, nonprofit publication that offers unbiased critical evaluations of drugs for physicians and other members of the health professions. This resource evaluates virtually all new drugs and also reviews older drugs when important new information becomes available on their usefulness or adverse effects.

APhA DrugInfoLine®

©2009 American Pharmacists Association (APhA)

APhA DrugInfoLine® is a monthly newsletter of interpreted drug and pharmacotherapeutic information designed to keep frontline pharmacists current on the latest trends in the biomedical literature.

New Titles, New Edition and Supplemental Updates: August 2009

New Titles:

The Official Guide for Foreign-Educated Nurses: What You Need to Know about Nursing and Health Care in the United States

©2009 Springer Publishing Company

This title is the only guide to the United States health care system for nurses immigrating to this country as well as foreign-educated nurses who are already here.

 

Comprehensive Nursing Care for Parkinson's Disease

©2007 Springer Publishing Company

The incidence of Parkinson's is growing as the number of older adults making up the general population increases. The demand for nurses who specialize in the care of patients with movement disorders is also increasing and it is crucial that they have a comprehensive manual for patient care.

 

New Edition:

Clinical Neuroanatomy 26th Ed.

©2010 McGraw-Hill Companies, Inc.

Learn the essential aspects of neuroanatomy and its clinical relevance with the field's most concise, trusted and effective title.

 

 

Supplemental Updates:

ACP Journal Club

©2009 by the American College of Physicians

ACP Journal Club, published by the American College of Physicians, is the quintessential EBM journal, and is often positioned near the top of the EBM pyramid.

ACP Medicine

©2009 BC Decker

ACP Medicine is the first comprehensive reference to carry the name of the American College of Physicians. Developed to help busy physicians keep up with changing guidelines in primary care, ACP Medicine is a continually updated, evidence-based reference of internal medicine.

ACP PIER, Journal Club & AHFS DI® Essentials™

©2009 by the American College of Physicians

A pre-appraised, evidence-based clinical tool that defines the standard of care, including value-added abstracts of original journal articles and drug treatment information.

•PIER (Physicians' Information and Education Resource) Integrated and authoritative EBM resources for the point-of-care and background reference.

•ACP Journal Club is the quintessential EBM journal that summarizes original research applicable to clinical cases.

•AHFS® DI Essentials™ distills the essential information from the larger AHFS Drug Information database.

ACP PIER & AHFS DI® Essentials™

©2009 ACP PIER: American College of Physicians

©2009 AHFS DI® Essentials™

PIER© is a collection of over 400 evidence summaries published by the American College of Physicians. Each module provides authoritative guidance to improve the quality of care.

ACP PIER®: Physicians' Information and Education Resource

©2009 ACP PIER: American College of Physicians

PIER© is a collection of over 400 evidence summaries published by the American College of Physicians. Each module provides authoritative guidance to improve the quality of care.

ACS Surgery: Principles and Practice

©2009 B.C. Decker

Published by B.C. Decker in collaboration with the American College of Surgeons (ACS), this continually updated reference, noted for its problem solving approach and numerous illustrations, is geared to the surgeon in practice. Master surgeons outline their preferred core general surgical procedure techniques.

AHFS Drug Information®

©2009 American Society of Health-System Pharmacists

With the 2009 edition, the American Hospital Formulary Service® (AHFS™) marks over 50 years of continuous publication by the American Society of Health-System Pharmacists (ASHP). Each year, an average of over 60% of AHFS content is revised to help you provide the most accurate recommendations for your patients’ drug therapy.

AHFS DI® Essentials™

©2009 by the American Society of Health-System Pharmacists, Inc.

AHFS DI® Essentials™ offers healthcare professionals easy access to knowledge that is critical at the point of care. Essentials™ monographs draw on the meticulously evidence-based guidelines in the full AHFS DI® database, distilling essential information on prescription and key over-the-counter (OTC) drugs in an easy-to-use and highly structured outline format

 

INFECTIOUS DISEASES: The Clinician's Guide to Diagnosis, Treatment, and Prevention

©2007 WebMD Inc.

This resource, derived from ACP Medicine, provides practical guidance on a wide range of infectious diseases such as upper respiratory infections, STDs and meningitis as well as viral, bacterial and fungal infections. It includes more than 4,000 focused, practical and current recommendations in addition to halftone and color illustrations.

Medical Letter® On Drugs and Therapeutics, The

©2009-1995 The Medical Letter, Inc.

The Medical Letter on Drugs and Therapeutics is an independent, nonprofit publication that offers unbiased critical evaluations of drugs for physicians and other members of the health professions. This resource evaluates virtually all new drugs and also reviews older drugs when important new information becomes available on their usefulness or adverse effects. It is only available to single users online and covers the period from 1995-2008.*

ACP Journal Club: What's New in March, 2009

ACP Journal Club
by Brian Haynes, MD, PhD
American College of Physicians (2008)

ACP Journal Club, published by the American College of Physicians, is the quintessential evidence-based journal and is often positioned near the top of the EBM pyramid. Published monthly, it selects articles from the biomedical literature that report original studies and systematic reviews that warrant immediate attention by physicians attempting to keep pace with important advances in internal medicine. These articles are then summarized in value-added abstracts and commented on by clinical experts.

Volume 150, Number 3

Therapeutics

•    Review: Perioperative β-blockers provide no clear benefit in patients having noncardiac surgery
•    Review: Long-acting β-agonists do not increase risk for asthma-related hospitalization in patients taking inhaled corticosteroids
•    Review: Inhaled corticosteroids do not reduce mortality but increase pneumonia in chronic obstructive pulmonary disease
•    Review: Enhanced oral hygiene prevents respiratory infection in older persons in hospitals and nursing homes
•    Intensive and standard glucose control did not differ for major CV events or death in poorly controlled type 2 diabetes
•    Combined therapy with folic acid and vitamins B6 and B12 did not affect cancer risk in women at high risk for CV disease
•    Selenium and vitamin E, alone or together, did not prevent prostate cancer
•    Vitamin E and vitamin C, alone or together, did not prevent prostate or total cancer in men
•    Prednisolone, but not valacyclovir, reduced time to complete recovery of facial-nerve function in Bell palsy

ACP Journal Club: What's New in February, 2009

ACP Journal Club
by Brian Haynes, MD, PhD
American College of Physicians (2008)

ACP Journal Club, published by the American College of Physicians, is the quintessential evidence-based journal and is often positioned near the top of the EBM pyramid. Published monthly, it selects articles from the biomedical literature that report original studies and systematic reviews that warrant immediate attention by physicians attempting to keep pace with important advances in internal medicine. These articles are then summarized in value-added abstracts and commented on by clinical experts.

Volume 150, Number 2

Therapeutics

•    Review: Low-molecular-weight heparin reduces risk for venous thromboembolism in adults with leg immobilization
•    Influenza immunization during pregnancy reduced influenza in infants and respiratory illness in mothers
•    Telmisartan did not reduce a composite of CV death, MI, HF, or stroke in high-risk patients intolerant to ACE inhibitors
•    High-dose vitamin B supplements did not slow cognitive decline in mild-to-moderate Alzheimer disease
•    Aspirin plus extended-release dipyridamole and clopidogrel were similarly effective for preventing recurrent stroke
•    Telmisartan did not prevent recurrent stroke or major cardiovascular events
•    Carotid artery stenting increased risk for stroke more than carotid endarterectomy in severe symptomatic stenosis
•    Carotid artery stenting and carotid endarterectomy were similarly effective in severe symptomatic stenosis
•    Intensive insulin therapy reduced long-term risk for incident hypertension in type 1 diabetes

Diagnosis

•    CT colonography had 90% sensitivity and 86% specificity for diagnosing large adenomas and cancer in asymptomatic adults

 Clinical Prediction Guide

•    Review: D-dimer levels predict risk for recurrent VTE after anticoagulant therapy is stopped
•    Review: Sgarbossa scores ≥ 3 have low sensitivity and high specificity for predicting MI in left bundle branch block

ACP Journal Club: What's New in January, 2009

ACP Journal Club
by Brian Haynes, MD, PhD
American College of Physicians (2008)

ACP Journal Club, published by the American College of Physicians, is the quintessential evidence-based journal and is often positioned near the top of the EBM pyramid. Published monthly, it selects articles from the biomedical literature that report original studies and systematic reviews that warrant immediate attention by physicians attempting to keep pace with important advances in internal medicine. These articles are then summarized in value-added abstracts and commented on by clinical experts.

Volume 150, Number 1

Therapeutics

•    Rosuvastatin prevented major cardiovascular events in persons with elevated C-reactive protein
•    Review: Tight glucose control reduces septicemia, but not death, and increases hypoglycemia in critically ill adults
•    Review: Inhaled anticholinergics increase risk for major cardiovascular events in chronic obstructive pulmonary disease
•    Tiotropium reduced exacerbations but not rate of FEV1 decline in patients with COPD using other respiratory medications
•    Aspirin and/or antioxidants did not prevent CV events in diabetes and peripheral arterial disease
•    Pioglitazone reduced liver injury and improved fasting glucose in nonalcoholic steatohepatitis without diabetes
•    Defibrillator therapy improved quality of life in CHF; amiodarone did not
•    n-3 polyunsaturated fatty acids reduced morbidity and mortality in chronic heart failure
•    Laparoscopic surgery was more effective than medical management for chronic gastroesophageal reflux disease
•    Alteplase given 3 to 4.5 hours after stroke reduced disability and improved global outcome
•    Immediate and delayed acupuncture reduced frequency and pain intensity of primary migraine or tension-type headaches
•    Arthroscopic surgery added no benefit to optimized physical and medical therapy in knee osteoarthritis

ACP Journal Club: What's New in December, 2008

ACP Journal Club
by Brian Haynes, MD, PhD
American College of Physicians (2008)

ACP Journal Club, published by the American College of Physicians, is the quintessential evidence-based journal and is often positioned near the top of the EBM pyramid. Published monthly, it selects articles from the biomedical literature that report original studies and systematic reviews that warrant immediate attention by physicians attempting to keep pace with important advances in internal medicine. These articles are then summarized in value-added abstracts and commented on by clinical experts.

Volume 149, Number 6

Therapeutics

• Benefits of early intensive glucose control to prevent diabetes complications were sustained for up to 10 years
• Benefits of tight blood pressure control to prevent diabetes complications were not sustained
• Review: Enteral or parenteral nutrition reduces risk for mortality in acute pancreatitis
• A combination of telmisartan and ramipril increased renal outcomes in vascular disease or diabetes
• Annual zoledronic acid did not increase renal abnormalities at 2 years in postmenopausal women with osteoporosis
• Noninvasive ventilation improved dyspnea but did not reduce short-term mortality in acute cardiogenic pulmonary edema
• Low-molecular-weight heparin for 7 days was more effective than compression stockings for preventing DVT in knee arthroscopy
• Review: Perioperative LMW heparin does not reduce mortality after surgery more than unfractionated heparin in patients with cancer
• Review: Custom-made foot orthoses are effective for some types of foot pain

Diagnosis

• A single measure of urinary neutrophil gelatinase-associated lipocalin was accurate for diagnosing acute kidney injury

Prognosis

• Review: Persons with epilepsy have higher risk for death by drowning than does the general population
• Review: Vasomotor symptoms peak at 1 year after final menstrual period and may persist for many years

ACP Journal Club: November 2008

ACP Journal Club
by Brian Haynes, MD, PhD
American College of Physicians (2008)

ACP Journal Club, published by the American College of Physicians, is the quintessential evidence-based journal and is often positioned near the top of the EBM pyramid. Published monthly, it selects articles from the biomedical literature that report original studies and systematic reviews that warrant immediate attention by physicians attempting to keep pace with important advances in internal medicine. These articles are then summarized in value-added abstracts and commented on by clinical experts.

Volume 149, Number 5

Therapeutics

• Review: Hemoglobin-based blood substitutes increase mortality and myocardial infarction in surgical, trauma, and stroke settings
• Review: Anticoagulation with INRs < 2 or between 3 and 5 increases risk for thromboembolic or hemorrhagic events
• Intensive and less-intensive renal replacement therapy did not differ for death or kidney function in critically ill patients
• Review: An early invasive strategy has similar benefits in men and women with NSTEMI or unstable angina
• Tibolone reduced risk for fractures and breast cancer but increased risk for stroke in older women with osteoporosis
• 4% lidocaine gel applied to the breasts before screening mammography reduced discomfort
• Review: Endoscopic plus drug therapy prevents rebleeding more than either one alone in cirrhosis with bleeding esophageal varices
• Review: Rifaximin is equally or more effective than other antibiotics and lactulose for hepatic encephalopathy
• Eradication of H. pylori after endoscopic resection for early gastric cancer reduced risk for metachronous gastric cancer
• Review: Psychological interventions prevent depression after stroke
  

  Prognosis

• 10-year risk for CV events was 10% to 56% in rheumatoid arthritis; risk was greatest for patients with CV risk factors
• Excess mortality after HIV seroconversion has greatly decreased in the past 10 years

ACP Journal Club: October 2008

ACP Journal Club
by Brian Haynes, MD, PhD
American College of Physicians (2008)

ACP Journal Club, published by the American College of Physicians, is the quintessential evidence-based journal and is often positioned near the top of the EBM pyramid. Published monthly, it selects articles from the biomedical literature that report original studies and systematic reviews that warrant immediate attention by physicians attempting to keep pace with important advances in internal medicine. These articles are then summarized in value-added abstracts and commented on by clinical experts.

Volume 149, Number 4

Therapeutics

• Glycemic control was not affected by self-monitoring of blood glucose in type 2 diabetes
• Thromboprophylaxis with rivaroxaban or enoxaparin did not differ for major bleeding or other safety outcomes in hip arthroplast
• Thromboprophylaxis with rivaroxaban or enoxaparin did not differ for major bleeding in knee arthroplasty
• Rhythm control and rate control did not differ for CV mortality in atrial fibrillation and congestive heart failure
• Review: Mifepristone is more effective for emergency contraception than levonorgestrel
• Review: Nonergot dopamine agonists reduce symptoms in the restless legs syndrome but may be discontinued due to adverse events
• An intervention involving pharmacist care via the Web improved blood pressure control in uncontrolled hypertension
• Adding single-point acupuncture to physiotherapy for painful shoulder improved function and reduced pain