American family physician
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American family physician · Sep 2013
Review Meta AnalysisTop 20 research studies of 2012 for primary care physicians.
This is the second annual summary of top research studies in primary care. In 2012, through regular surveillance of more than 100 English-language clinical research journals, seven clinicians identified 270 studies with the potential to change primary care practice, called POEMs, or patient-oriented evidence that matters. ⋯ A validated tool was used to obtain feedback from these physicians about the clinical relevance of each POEM and the benefits the physicians expected for their practice. The 20 identified research studies rated as most relevant cover common topics such as diabetes mellitus, cardiovascular disease prevention, infectious disease, musculoskeletal disease and exercise, cancer screening, and women's health.
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Prolactinomas and nonfunctioning adenomas are the most common types of pituitary adenomas. Patients with pituitary adenomas may present initially with symptoms of endocrine dysfunction such as infertility, decreased libido, and galactorrhea, or with neurologic symptoms such as headache and visual changes. The diagnosis may also be made following imaging done for an unrelated issue in an asymptomatic patient; this is termed a pituitary incidentaloma. ⋯ Therapy for pituitary adenomas depends on the specific type of tumor, and should be managed with a team approach to include endocrinology and neurosurgery when indicated. Dopamine agonists are the primary treatment for prolactinomas. Small nonfunctioning adenomas and prolactinomas in asymptomatic patients do not require immediate intervention and can be observed.