A medical certificate is the principal way physicians communicate an employee's illness or injury... more A medical certificate is the principal way physicians communicate an employee's illness or injury to the employer. The employer is entitled to nonspecific information as to whether or not the physician considers the release from work to be legitimate and whether the employee has any medical problems that might interfere with job performance or make the employee a health risk to self or to others on the job. Specific information about diagnosis is only required when an injury or illness is related to workers' compensation.
Synopsis: Angiotensin-converting enzyme (ACE) inhibitors are known to slow the increase in serum ... more Synopsis: Angiotensin-converting enzyme (ACE) inhibitors are known to slow the increase in serum creatinine levels in patients with or without diabetes who have mild to moderate renal insufficiency (serum creatinine= 1.5 to 3.0 mg per dL [130 to 270 μmol per L]).
Written at the clerkship level, this book is a comprehensive introduction to family medicine. It ... more Written at the clerkship level, this book is a comprehensive introduction to family medicine. It is organized into three sections-principles of family medicine, preventive care, and common problems-and includes chapters on evidence-based medicine and complementary therapies. The text has a user-friendly writing style, focuses on common clinical problems, and uses case studies to show practical applications of key concepts.
1. Am Fam Physician. 2004 Dec 1;70(11):2109-10. Link between metformin and lactic acidosis? Ebell... more 1. Am Fam Physician. 2004 Dec 1;70(11):2109-10. Link between metformin and lactic acidosis? Ebell M. PMID: 15606058 [PubMed - indexed for MEDLINE]. Publication Types: Review. MeSH Terms. Acidosis, Lactic/chemically induced*; Evidence-Based Medicine; Humans; Hypoglycemic Agents/adverse effects*; Metformin/adverse effects*. Substances. Hypoglycemic Agents; Metformin.
Synopsis: Many patients avoid coffee, often on the advice of their physicians, because of concern... more Synopsis: Many patients avoid coffee, often on the advice of their physicians, because of concerns that it may increase the risk of heart disease. The largest and longest study to date on the subject combines data from the Health Professionals Follow-up Study (n= 44,005) and the Nurses' Health Study (n= 84,488). These studies began in 1986 and 1976, respectively, and provide 14 and 20 years of follow-up.
Synopsis: A variety of outcomes are used in studies of venous thromboembolism prophylaxis for sur... more Synopsis: A variety of outcomes are used in studies of venous thromboembolism prophylaxis for surgical patients, ranging from the disease-oriented (asymptomatic radiographically detected deep venous thrombosis [DVT]) to the patient-oriented (death from any cause). Four studies compared fondaparinux with enoxaparin in patients undergoing major orthopedic surgery, and each included asymptomatic distal DVTs in its combined outcome.
1. Fam Pract Manag. 2004 Nov-Dec;11(10):71-2. Estimating the risks of coronary angioplasty. Ebell... more 1. Fam Pract Manag. 2004 Nov-Dec;11(10):71-2. Estimating the risks of coronary angioplasty. Ebell MH. Department of Family Practice, Michigan State University College of Human Medicine, East Lansing, USA. PMID: 15575144 [PubMed - indexed for MEDLINE]. MeSH Terms. Angioplasty, Balloon, Coronary/adverse effects*; Coronary Artery Disease/surgery*; Decision Making*; Humans; Informed Consent; Male; Middle Aged; Practice Guidelines as Topic; Risk Assessment*.
Synopsis: In this manufacturer-sponsored study, investigators identified black adult patients wit... more Synopsis: In this manufacturer-sponsored study, investigators identified black adult patients with a left ventricular ejection fraction of no greater than 35 percent (or less than 45 percent with a reduced left ventricular internal, end-diastolic diameter). Exclusion criteria included acute myocardial infarction, acute coronary syndrome, recent stroke, recent cardiac surgery or angioplasty, valvular heart disease, or hypotension or uncontrolled hypertension. The primary outcome was a composite of death, hospitalization, and change in quality of life.
Synopsis: Although tricyclic antidepressants are somewhat effective for the treatment of IBS, it ... more Synopsis: Although tricyclic antidepressants are somewhat effective for the treatment of IBS, it is less clear whether SSRIs are similarly helpful. Patients in this study came from two groups:(1) those on a low-fiber diet who presented to a gastroenterologist and did not improve on a subsequent high-fiber diet; and (2) those already eating a high-fiber diet when they presented for care.
Synopsis: It is thought that bloating and flatulence, especially troublesome in patients with irr... more Synopsis: It is thought that bloating and flatulence, especially troublesome in patients with irritable bowel syndrome (IBS), may be caused by bacterial overgrowth in the small intestine. The theory is that this overgrowth can be detected by measuring hydrogen released during bacterial carbohydrate fermentation with a lactulose hydrogen breath test (LHBT). Previous studies with neomycin to kill these bacteria have provided promising results, but symptoms recurred quickly after the antibiotic was discontinued.
Synopsis: In this study, women older than 65 years with a positive urine culture and at least one... more Synopsis: In this study, women older than 65 years with a positive urine culture and at least one symptom of UTI were randomized to receive oral ciprofloxacin in a dosage of 250 mg twice daily for three days plus placebo for four days (n= 93) or ciprofloxacin in a dosage of 250 mg twice daily for seven days (n= 89). Women with diabetes, an indwelling catheter, abnormal renal function, sepsis, recent use of antibiotics, or signs of pyelonephritis (not specified) were excluded.
Synopsis: Tamoxifen is the current standard of care for the treatment of estrogen-receptor–positi... more Synopsis: Tamoxifen is the current standard of care for the treatment of estrogen-receptor–positive breast cancer in postmenopausal women. Exemestane is an aromatase inhibitor that blocks the conversion of androgens to estrogen and may be superior to tamoxifen in patients with metastatic disease.
Synopsis: The authors of this study performed a thorough search of the literature to identify all... more Synopsis: The authors of this study performed a thorough search of the literature to identify all studies of rest versus early mobilization for acute limb injuries, including fractures, strains, sprains, and other soft tissue injuries. Included were randomized controlled trials with less than 20 percent loss to follow-up (or an intention-to-treat analysis), trials that studied mostly adults, and those with adequate data reporting. The authors identified 187 potential articles, of which 49 met the inclusion criteria.
Synopsis: Physicians in this study, which was conducted in England, had the option of referring p... more Synopsis: Physicians in this study, which was conducted in England, had the option of referring patients for an urgent endoscopy if they felt it was indicated. Patients eligible for urgent endoscopy were those at least 55 years of age, those with alarm symptoms (eg, dysphagia, anorexia, vomiting, weight loss, anemia), and those in whom one or more high-risk features were present (eg, family history, Barrett's esophagus, pernicious anemia, peptic ulcer surgery, known dysplasia).
A medical certificate is the principal way physicians communicate an employee's illness or injury... more A medical certificate is the principal way physicians communicate an employee's illness or injury to the employer. The employer is entitled to nonspecific information as to whether or not the physician considers the release from work to be legitimate and whether the employee has any medical problems that might interfere with job performance or make the employee a health risk to self or to others on the job. Specific information about diagnosis is only required when an injury or illness is related to workers' compensation.
Synopsis: Angiotensin-converting enzyme (ACE) inhibitors are known to slow the increase in serum ... more Synopsis: Angiotensin-converting enzyme (ACE) inhibitors are known to slow the increase in serum creatinine levels in patients with or without diabetes who have mild to moderate renal insufficiency (serum creatinine= 1.5 to 3.0 mg per dL [130 to 270 μmol per L]).
Written at the clerkship level, this book is a comprehensive introduction to family medicine. It ... more Written at the clerkship level, this book is a comprehensive introduction to family medicine. It is organized into three sections-principles of family medicine, preventive care, and common problems-and includes chapters on evidence-based medicine and complementary therapies. The text has a user-friendly writing style, focuses on common clinical problems, and uses case studies to show practical applications of key concepts.
1. Am Fam Physician. 2004 Dec 1;70(11):2109-10. Link between metformin and lactic acidosis? Ebell... more 1. Am Fam Physician. 2004 Dec 1;70(11):2109-10. Link between metformin and lactic acidosis? Ebell M. PMID: 15606058 [PubMed - indexed for MEDLINE]. Publication Types: Review. MeSH Terms. Acidosis, Lactic/chemically induced*; Evidence-Based Medicine; Humans; Hypoglycemic Agents/adverse effects*; Metformin/adverse effects*. Substances. Hypoglycemic Agents; Metformin.
Synopsis: Many patients avoid coffee, often on the advice of their physicians, because of concern... more Synopsis: Many patients avoid coffee, often on the advice of their physicians, because of concerns that it may increase the risk of heart disease. The largest and longest study to date on the subject combines data from the Health Professionals Follow-up Study (n= 44,005) and the Nurses' Health Study (n= 84,488). These studies began in 1986 and 1976, respectively, and provide 14 and 20 years of follow-up.
Synopsis: A variety of outcomes are used in studies of venous thromboembolism prophylaxis for sur... more Synopsis: A variety of outcomes are used in studies of venous thromboembolism prophylaxis for surgical patients, ranging from the disease-oriented (asymptomatic radiographically detected deep venous thrombosis [DVT]) to the patient-oriented (death from any cause). Four studies compared fondaparinux with enoxaparin in patients undergoing major orthopedic surgery, and each included asymptomatic distal DVTs in its combined outcome.
1. Fam Pract Manag. 2004 Nov-Dec;11(10):71-2. Estimating the risks of coronary angioplasty. Ebell... more 1. Fam Pract Manag. 2004 Nov-Dec;11(10):71-2. Estimating the risks of coronary angioplasty. Ebell MH. Department of Family Practice, Michigan State University College of Human Medicine, East Lansing, USA. PMID: 15575144 [PubMed - indexed for MEDLINE]. MeSH Terms. Angioplasty, Balloon, Coronary/adverse effects*; Coronary Artery Disease/surgery*; Decision Making*; Humans; Informed Consent; Male; Middle Aged; Practice Guidelines as Topic; Risk Assessment*.
Synopsis: In this manufacturer-sponsored study, investigators identified black adult patients wit... more Synopsis: In this manufacturer-sponsored study, investigators identified black adult patients with a left ventricular ejection fraction of no greater than 35 percent (or less than 45 percent with a reduced left ventricular internal, end-diastolic diameter). Exclusion criteria included acute myocardial infarction, acute coronary syndrome, recent stroke, recent cardiac surgery or angioplasty, valvular heart disease, or hypotension or uncontrolled hypertension. The primary outcome was a composite of death, hospitalization, and change in quality of life.
Synopsis: Although tricyclic antidepressants are somewhat effective for the treatment of IBS, it ... more Synopsis: Although tricyclic antidepressants are somewhat effective for the treatment of IBS, it is less clear whether SSRIs are similarly helpful. Patients in this study came from two groups:(1) those on a low-fiber diet who presented to a gastroenterologist and did not improve on a subsequent high-fiber diet; and (2) those already eating a high-fiber diet when they presented for care.
Synopsis: It is thought that bloating and flatulence, especially troublesome in patients with irr... more Synopsis: It is thought that bloating and flatulence, especially troublesome in patients with irritable bowel syndrome (IBS), may be caused by bacterial overgrowth in the small intestine. The theory is that this overgrowth can be detected by measuring hydrogen released during bacterial carbohydrate fermentation with a lactulose hydrogen breath test (LHBT). Previous studies with neomycin to kill these bacteria have provided promising results, but symptoms recurred quickly after the antibiotic was discontinued.
Synopsis: In this study, women older than 65 years with a positive urine culture and at least one... more Synopsis: In this study, women older than 65 years with a positive urine culture and at least one symptom of UTI were randomized to receive oral ciprofloxacin in a dosage of 250 mg twice daily for three days plus placebo for four days (n= 93) or ciprofloxacin in a dosage of 250 mg twice daily for seven days (n= 89). Women with diabetes, an indwelling catheter, abnormal renal function, sepsis, recent use of antibiotics, or signs of pyelonephritis (not specified) were excluded.
Synopsis: Tamoxifen is the current standard of care for the treatment of estrogen-receptor–positi... more Synopsis: Tamoxifen is the current standard of care for the treatment of estrogen-receptor–positive breast cancer in postmenopausal women. Exemestane is an aromatase inhibitor that blocks the conversion of androgens to estrogen and may be superior to tamoxifen in patients with metastatic disease.
Synopsis: The authors of this study performed a thorough search of the literature to identify all... more Synopsis: The authors of this study performed a thorough search of the literature to identify all studies of rest versus early mobilization for acute limb injuries, including fractures, strains, sprains, and other soft tissue injuries. Included were randomized controlled trials with less than 20 percent loss to follow-up (or an intention-to-treat analysis), trials that studied mostly adults, and those with adequate data reporting. The authors identified 187 potential articles, of which 49 met the inclusion criteria.
Synopsis: Physicians in this study, which was conducted in England, had the option of referring p... more Synopsis: Physicians in this study, which was conducted in England, had the option of referring patients for an urgent endoscopy if they felt it was indicated. Patients eligible for urgent endoscopy were those at least 55 years of age, those with alarm symptoms (eg, dysphagia, anorexia, vomiting, weight loss, anemia), and those in whom one or more high-risk features were present (eg, family history, Barrett's esophagus, pernicious anemia, peptic ulcer surgery, known dysplasia).
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