Should we be giving our women steroids prior to elective caesarean section?

Delivery by elective caesarean section at less than 39+0 weeks of gestation can lead to respiratory morbidity in neonates, requiring admission to the neonatal intensive care unit A recent retrospective cohort study showed that, compared with elective caesarean section births at 39+0 weeks of gestation, births at 37+0 weeks...

CKD goals, what am I doing with this raised PTH?

Phosphate-Binding Agents in Adults With CKD: A Network Meta-analysis of Randomised Trials.  Suetonia C. Palmer, PhD, Sharon Gardner, MA, Marcello Tonelli, MD, Dimitris Mavridis, PhD, David W. Johnson, PhD, Jonathan C. Craig, PhD, Richard French, MBChB, Marinella Ruospo, MScMed, Giovanni F.M. Strippoli, PhD’Correspondence information about the author PhD Giovanni...

Smoking cessation: Is abrupt quitting more effective than a gradual approach?

Lindson-Hawley N, Banting M, West R, Michie S, Shinkins B, Aveyard P. Gradual versus abrupt smoking cessation. A randomized, controlled noninferiority trial. Ann Intern Med 2016;164(9):585-592. Patients in the “abrupt cessation group” were asked to stop smoking on their quit day. Participants in the “gradual cessation group” were also...

Lung ultrasound for paediatric pneumonia

Q. Can Lung ultrasound reduce need for CXR in children with suspected pneumonia? Jones BP, Tay ET, Elikashvili I, et al. Feasibility and safety of substituting lung ultrasonography for chest radiography when diagnosing pneumonia in children: a randomized controlled trial. Chest 2016;150(1):131-138. randomized 191 children and adolescents with clinically suspected...

What is the best duration for nicotine replacement therapy?

  —525 smokers enrolled. —Randomized groups for nicotine replacement via patch at 8, 24, 52 weeks —6 month cessation rates were significantly higher if patches used for 24 wks. vs 8 wks. —No adverse effects noted —Cost effective benefit long term. —No additional therapeutic advantage with long term treatment...

POEM 16.03.17

Q. How do I treat resistant Mycoplasma Genitalium? ›Management of Mycoplasma genitalium infections – can we hit a moving target? BMC Infect Dis. 2015 Review and meta-analysis of 19 studies Azithromycin standard single dose failure (40%) No randomised controlled trial has compared azithromycin 1 g single dose with extended azithromycin...

POEM 15.03.17

  Q How well can we predict the risk of developing asthma in preschool children? A simple asthma prediction tool for preschool children with wheeze or cough.  J Allergy Clin Immunol. 2014 10 predictors with total score between 0 -15: sex, age, wheeze without colds, wheeze frequency, activity disturbance,...

POEM 14.03.17

Patient Oriented Evidence that Matters Q. Is it ok to give droperidol to this psychotic gentleman? The Safety and Effectiveness of Droperidol for Sedation of Acute Behavioral Disturbance in the Emergency Department. Ann Emerg Med. 2015  1403 patients 10mg droperidol IM, IV Mean time to sedation 20mins Additional dosing required...

POEM 10.03.17

Patient Oriented Evidence that Matters Q. Low dose Perindopril…whats the point? RAS inhibitors’ dose-dependent efficacy: myth or reality?[Curr Med Res Opin. 2015] Perindopril is the only ACE inhibitor to show a real dose-response curve for BP decrease. While the effectiveness of RAS blockers on target organ damage is dose...

POEM 03.03.17

Patient Orientated Evidence that Matters Do I need to wake up my Anaesthetist to perform a procedural sedation? Intra-articular lignocaine (IAL) versus intravenous analgesia with or without sedation (IVAS) for manual reduction of acute anterior shoulder dislocation in adults. First published: 13 April 2011 Authors Conclusions: We observed no...