J Am Board Fam Med
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Meta Analysis
Signs and Symptoms That Rule out Community-Acquired Pneumonia in Outpatient Adults: A Systematic Review and Meta-Analysis.
A systematic review of clinical decision rules to identify patients at low risk for community-acquired pneumonia (CAP) has not been previously presented in the literature. ⋯ Adults with an acute respiratory infection who have normal vital signs and a normal pulmonary examination are very unlikely to have CAP. Given a baseline CAP risk of 4%, these patients have only a 0.4% likelihood of CAP.
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There is increasing demand for managing depressive and/or anxiety disorders among primary care patients. Problem-solving therapy (PST) is a brief evidence- and strength-based psychotherapy that has received increasing support for its effectiveness in managing depression and anxiety among primary care patients. ⋯ Results from the study supported PST's effectiveness for primary care depression and/or anxiety. Our preliminary results also indicated that physician-involved PST offers meaningful improvements for primary care patients' depression and/or anxiety.
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Review Meta Analysis
Clinical Diagnosis of Bordetella Pertussis Infection: A Systematic Review.
Bordetella pertussis (BP) is a common cause of prolonged cough. Our objective was to perform an updated systematic review of the clinical diagnosis of BP without restriction by patient age. ⋯ The clinician's overall impression was the most accurate way to determine the likelihood of BP infection when a patient initially presented. Clinical decision rules that combine signs, symptoms, and point-of-care tests have not yet been developed or validated.
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Nausea and vomiting in early pregnancy (NVEP) is commonly encountered in family medicine. Ginger (Zingiber officinale) is a popular nonpharmacological treatment but consensus of its use is lacking. ⋯ Despite the widespread use of ginger in the diet, its clinic value and safety profile in treating NVEP is still unknown. Our meta-analysis suggests that ginger is an effective nonpharmacological treatment for NVEP.