The Journal of family practice
-
NO. In general, nonoral estrogen use for menopausal symptoms is associated with a lower cardiovascular (CV) risk profile than oral estrogen use (strength of recommendation [SOR], B; meta-analysis of cohort studies). ⋯ Vaginal estrogen therapy also is associated with lower CV-related mortality for 3 to 5 years compared withnonuse (SOR, B; cohort study). No high-quality randomized trials address this topic.
-
Multicenter Study
A new standard for treatment of torus fractures of the wrist?
A large multicenter trial evaluated effects on pain and function for pediatric patients treated with a soft bandage vs rigid immobilization.
-
Randomized Controlled Trial
Is low-dose naltrexone effective in chronic pain management?
YES. Low-dose naltrexone is as effective as amitriptyline in the treatment of painful diabetic neuropathy and has a superior safety profile (strength of recommendation [SOR], B; single randomized controlled trial [RCT]). Low-dose naltrexone significantly reduced pain by 32% in inflammatory conditions and 44% in neuropathic conditions (SOR, B; single retrospective cohort study). Doses as low as 5.4 mg were found to reduce pain in 95% of patients with fibromyalgia (SOR, B; single prospective dose-response study).
-
Review Meta Analysis
Should antenatal testing be performed in patients with a pre-pregnancy BMI ≥ 35?
Possibly. Elevated BMI is associated with an increased risk for stillbirth (strength of recommendation [SOR], B; cohort studies and meta-analysis of cohort studies). Three studies found an association between elevated BMI and stillbirth and one did not. However, no studies demonstrate that antenatal testing in pregnant people with higher BMIs decreases stillbirth rates, or that no harm is caused by unnecessary testing or resultant interventions.
-
Case Reports
51-year-old woman • History of Graves disease • General fatigue, palpitations, and hand tremors • Dx?
► history of Graves disease ► general fatigue, palpitations, and hand tremors.