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Ten years after bariatric surgery: weight loss sustained, diabetes and hypertension reversed
Bariatric surgery successfully helps patients lose weight and reverse diabetes, hypertension, and some hyperlipidemias. We still do not know whether it affects all-cause mortality. (LOE=2c)
Bariatric surgery successfully helps patients lose weight and reverse diabetes, hypertension, and some hyperlipidemias. We still do not know whether it affects all-cause mortality. (LOE=2c)
Bariatric surgery successfully helps patients lose weight and reverse diabetes, hypertension, and some hyperlipidemias. We still do not know whether it affects all-cause mortality. (LOE=2c)
Use CCBs as last resort in treatment of hypertension
In women with hypertension and no history of cardiovascular disease (CVD), a regimen of a diuretic plus either a beta-blocker or angiotensin-converting enzyme (ACE) inhibitor reduces the risk of CVD mortality compared with a diuretic plus calcium channel blocker. The evidence continues to mount that calcium channel blockers should be the agent of last resort in the treatment of most patients with hypertension. (LOE=2b–)
In women with hypertension and no history of cardiovascular disease (CVD), a regimen of a diuretic plus either a beta-blocker or angiotensin-converting enzyme (ACE) inhibitor reduces the risk of CVD mortality compared with a diuretic plus calcium channel blocker. The evidence continues to mount that calcium channel blockers should be the agent of last resort in the treatment of most patients with hypertension. (LOE=2b–)
In women with hypertension and no history of cardiovascular disease (CVD), a regimen of a diuretic plus either a beta-blocker or angiotensin-converting enzyme (ACE) inhibitor reduces the risk of CVD mortality compared with a diuretic plus calcium channel blocker. The evidence continues to mount that calcium channel blockers should be the agent of last resort in the treatment of most patients with hypertension. (LOE=2b–)
Acupuncture effective for osteoarthritis of the knee
Acupuncture, as compared with sham acupuncture treatment or no treatment, decreases pain scores by an average of 40% and improves function similarly in patients who stick with it. The acupuncture used in this study was based on the Traditional Chinese Medicine meridian theory and was used for the entire 6 months of the study. (LOE=1b)
Acupuncture, as compared with sham acupuncture treatment or no treatment, decreases pain scores by an average of 40% and improves function similarly in patients who stick with it. The acupuncture used in this study was based on the Traditional Chinese Medicine meridian theory and was used for the entire 6 months of the study. (LOE=1b)
Acupuncture, as compared with sham acupuncture treatment or no treatment, decreases pain scores by an average of 40% and improves function similarly in patients who stick with it. The acupuncture used in this study was based on the Traditional Chinese Medicine meridian theory and was used for the entire 6 months of the study. (LOE=1b)
Vitamin E not helpful, perhaps harmful
Vitamin E supplementation does not decrease all-cause mortality in patients with or without pre-existing heart disease. At higher doses it can actually be harmful, although the deleterious effect is small (number needed to harm [NNH]=250). (level of evidence [LOE]=1b)
Vitamin E supplementation does not decrease all-cause mortality in patients with or without pre-existing heart disease. At higher doses it can actually be harmful, although the deleterious effect is small (number needed to harm [NNH]=250). (level of evidence [LOE]=1b)
Vitamin E supplementation does not decrease all-cause mortality in patients with or without pre-existing heart disease. At higher doses it can actually be harmful, although the deleterious effect is small (number needed to harm [NNH]=250). (level of evidence [LOE]=1b)
Cost-effective management for nephrolithiasis
For patients with first-time kidney stones, conservative therapy (dietary modification only) is the most cost-effective strategy. In recurrent stone formers, both empiric therapy (dietary modification and potassium citrate) and a modified simple metabolic evaluation (one 24-hour urine collection for renal stone risk factors, with both potassium citrate and hydrochlorothiazide for patients with hypercalciuria and potassium citrate alone for patients with normocalciuria) are equally cost-effective. (LOE=2b)
For patients with first-time kidney stones, conservative therapy (dietary modification only) is the most cost-effective strategy. In recurrent stone formers, both empiric therapy (dietary modification and potassium citrate) and a modified simple metabolic evaluation (one 24-hour urine collection for renal stone risk factors, with both potassium citrate and hydrochlorothiazide for patients with hypercalciuria and potassium citrate alone for patients with normocalciuria) are equally cost-effective. (LOE=2b)
For patients with first-time kidney stones, conservative therapy (dietary modification only) is the most cost-effective strategy. In recurrent stone formers, both empiric therapy (dietary modification and potassium citrate) and a modified simple metabolic evaluation (one 24-hour urine collection for renal stone risk factors, with both potassium citrate and hydrochlorothiazide for patients with hypercalciuria and potassium citrate alone for patients with normocalciuria) are equally cost-effective. (LOE=2b)
Adding ACE inhibitor doesn’t improve outcomes in stable angina and normal LVEF
Adding the angiotensin-converting enzyme (ACE) inhibitor trandolapril (Mavik) to standard medical treatment of patients with stable angina and normal left ventricular function did not reduce their risk of adverse cardiovascular outcomes. Although higher-risk patients and those with less well controlled risk factors may still benefit from this intervention, this study didn’t assess those groups. (LOE=1b)
Adding the angiotensin-converting enzyme (ACE) inhibitor trandolapril (Mavik) to standard medical treatment of patients with stable angina and normal left ventricular function did not reduce their risk of adverse cardiovascular outcomes. Although higher-risk patients and those with less well controlled risk factors may still benefit from this intervention, this study didn’t assess those groups. (LOE=1b)
Adding the angiotensin-converting enzyme (ACE) inhibitor trandolapril (Mavik) to standard medical treatment of patients with stable angina and normal left ventricular function did not reduce their risk of adverse cardiovascular outcomes. Although higher-risk patients and those with less well controlled risk factors may still benefit from this intervention, this study didn’t assess those groups. (LOE=1b)
ARB no better than ACE inhibitor for prevention of nephropathy progression
Despite a relatively low dose of 10 mg given once a day, enalapril (Vasotec) was at least as effective as telmisartan (Micardis) and showed a trend toward greater benefit in preventing decline in glomerular filtration rate. Although this study measured a disease-oriented endpoint, its results are consistent with the body of literature that supports the less expensive angiotensin-converting enzyme (ACE) inhibitors as the drug of choice over angiotensin receptor blockers (ARBs). (LOE=1b)
Despite a relatively low dose of 10 mg given once a day, enalapril (Vasotec) was at least as effective as telmisartan (Micardis) and showed a trend toward greater benefit in preventing decline in glomerular filtration rate. Although this study measured a disease-oriented endpoint, its results are consistent with the body of literature that supports the less expensive angiotensin-converting enzyme (ACE) inhibitors as the drug of choice over angiotensin receptor blockers (ARBs). (LOE=1b)
Despite a relatively low dose of 10 mg given once a day, enalapril (Vasotec) was at least as effective as telmisartan (Micardis) and showed a trend toward greater benefit in preventing decline in glomerular filtration rate. Although this study measured a disease-oriented endpoint, its results are consistent with the body of literature that supports the less expensive angiotensin-converting enzyme (ACE) inhibitors as the drug of choice over angiotensin receptor blockers (ARBs). (LOE=1b)
Tight blood pressure control prevents blindness in patients with diabetes
Tight blood pressure control results in a small benefit in the prevention of blindness, with a number needed to treat of 1000 per year. Tight control was also associated with a reduction in loss of visual acuity after 9 years (but not with shorter durations of follow-up) and an increase in the likelihood of cataract extraction. (LOE=1b)
Tight blood pressure control results in a small benefit in the prevention of blindness, with a number needed to treat of 1000 per year. Tight control was also associated with a reduction in loss of visual acuity after 9 years (but not with shorter durations of follow-up) and an increase in the likelihood of cataract extraction. (LOE=1b)
Tight blood pressure control results in a small benefit in the prevention of blindness, with a number needed to treat of 1000 per year. Tight control was also associated with a reduction in loss of visual acuity after 9 years (but not with shorter durations of follow-up) and an increase in the likelihood of cataract extraction. (LOE=1b)
Useful treatments for fibromyalgia syndrome
Treatments for fibromyalgia syndrome with the strongest evidence for efficacy include amitriptyline (Elavil), cyclobenzaprine (Flexeril), exercise, cognitive behavioral therapy, patient education, and multidisciplinary therapy. (Level of evidence [LOE]=1a–)
Treatments for fibromyalgia syndrome with the strongest evidence for efficacy include amitriptyline (Elavil), cyclobenzaprine (Flexeril), exercise, cognitive behavioral therapy, patient education, and multidisciplinary therapy. (Level of evidence [LOE]=1a–)
Treatments for fibromyalgia syndrome with the strongest evidence for efficacy include amitriptyline (Elavil), cyclobenzaprine (Flexeril), exercise, cognitive behavioral therapy, patient education, and multidisciplinary therapy. (Level of evidence [LOE]=1a–)