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Heart failure in patients treated with bisphosphonates
ConclusionsBisphosphonate users were at increased risk of heart failure compared to age‐ and gender‐matched control subjects. However, users of alendronate showed a dose‐dependent reduction of this risk, suggesting that alendronate may reduce the risk of heart failure.This article is protected by copyright. All rights reserved. (Source: Journal of Internal Medicine)
Source: Journal of Internal Medicine - May 16, 2013 Category: Internal Medicine Authors: Erik Lerkevang Grove, Bo Abrahamsen, Peter Vestergaard Tags: Original Article Source Type: research

The Role of the NIH in Nurturing Clinician-Scientists
New England Journal of Medicine, Volume 0, Issue 0, Ahead of Print. (Source: New England Journal of Medicine)
Source: New England Journal of Medicine - May 16, 2013 Category: Internal Medicine Tags: article Source Type: research

Personalized medicine in psychiatry: problems and promises
The central theme of personalized medicine is the premise that an individual's unique physiologic characteristics play a significant role in both disease vulnerability and in response to specific therapies. The major goals of personalized medicine are therefore to predict an individual's susceptibility to developing an illness, achieve accurate diagnosis, and optimize the most efficient and favorable response to treatment. The goal of achieving personalized medicine in psychiatry is a laudable one, because its attainment should be associated with a marked reduction in morbidity and mortality. In this review, we summarize a...
Source: BMC Medicine - May 16, 2013 Category: Internal Medicine Authors: Uzoezi OzomaroClaes WahlestedtCharles Nemeroff Source Type: research

Oxygen-Saturation Targets in Extremely Preterm Infants
New England Journal of Medicine, Volume 368, Issue 20, Page 1949-1950, May 2013. (Source: New England Journal of Medicine)
Source: New England Journal of Medicine - May 15, 2013 Category: Internal Medicine Tags: article Source Type: research

Putting Aside Preconceptions — Time for Dialogue among Primary Care Clinicians
New England Journal of Medicine, Volume 368, Issue 20, Page 1933-1934, May 2013. (Source: New England Journal of Medicine)
Source: New England Journal of Medicine - May 15, 2013 Category: Internal Medicine Tags: article Source Type: research

Ondansetron for Diarrhea Associated with Neuroendocrine Tumors
New England Journal of Medicine, Volume 368, Issue 20, Page 1947-1948, May 2013. (Source: New England Journal of Medicine)
Source: New England Journal of Medicine - May 15, 2013 Category: Internal Medicine Tags: article Source Type: research

Public Funding of and Access to In Vitro Fertilization
New England Journal of Medicine, Volume 368, Issue 20, Page 1948-1949, May 2013. (Source: New England Journal of Medicine)
Source: New England Journal of Medicine - May 15, 2013 Category: Internal Medicine Tags: article Source Type: research

Current and Future Therapies for Hepatitis C Virus Infection
New England Journal of Medicine, Volume 368, Issue 20, Page 1907-1917, May 2013. (Source: New England Journal of Medicine)
Source: New England Journal of Medicine - May 15, 2013 Category: Internal Medicine Tags: article Source Type: research

Pyostomatitis Vegetans
New England Journal of Medicine, Volume 368, Issue 20, Page 1918, May 2013. (Source: New England Journal of Medicine)
Source: New England Journal of Medicine - May 15, 2013 Category: Internal Medicine Tags: article Source Type: research

Case 15-2013
New England Journal of Medicine, Volume 368, Issue 20, Page 1919-1927, May 2013. (Source: New England Journal of Medicine)
Source: New England Journal of Medicine - May 15, 2013 Category: Internal Medicine Tags: article Source Type: research

Rivaroxaban for Thromboprophylaxis in Acutely Ill Medical Patients
New England Journal of Medicine, Volume 368, Issue 20, Page 1944-1946, May 2013. (Source: New England Journal of Medicine)
Source: New England Journal of Medicine - May 15, 2013 Category: Internal Medicine Tags: article Source Type: research

More on Confusion of Drug Names
New England Journal of Medicine, Volume 368, Issue 20, Page 1946-1947, May 2013. (Source: New England Journal of Medicine)
Source: New England Journal of Medicine - May 15, 2013 Category: Internal Medicine Tags: article Source Type: research

Hepatitis C in the United States
New England Journal of Medicine, Volume 368, Issue 20, Page 1859-1861, May 2013. (Source: New England Journal of Medicine)
Source: New England Journal of Medicine - May 15, 2013 Category: Internal Medicine Tags: article Source Type: research

Perspectives of Physicians and Nurse Practitioners on Primary Care Practice
New England Journal of Medicine, Volume 368, Issue 20, Page 1898-1906, May 2013. (Source: New England Journal of Medicine)
Source: New England Journal of Medicine - May 15, 2013 Category: Internal Medicine Tags: article Source Type: research

Persistent Hemichorea
New England Journal of Medicine, Volume 368, Issue 20, May 2013. (Source: New England Journal of Medicine)
Source: New England Journal of Medicine - May 15, 2013 Category: Internal Medicine Tags: article Source Type: research

Expanding the Role of Advanced Nurse Practitioners — Risks and Rewards
New England Journal of Medicine, Volume 368, Issue 20, Page 1935-1941, May 2013. (Source: New England Journal of Medicine)
Source: New England Journal of Medicine - May 15, 2013 Category: Internal Medicine Tags: article Source Type: research

Tumor–Stromal Interactions in Medulloblastoma
New England Journal of Medicine, Volume 368, Issue 20, Page 1942-1943, May 2013. (Source: New England Journal of Medicine)
Source: New England Journal of Medicine - May 15, 2013 Category: Internal Medicine Tags: article Source Type: research

Teriparatide-Denosumab Combo Strengthens Postmenopausal BoneTeriparatide-Denosumab Combo Strengthens Postmenopausal Bone
A combination of teriparatide, which builds bone, and denosumab, which reduces bone loss, improved bone density in postmenopausal women compared with either drug alone. Medscape Medical News (Source: Medscape Today Headlines)
Source: Medscape Today Headlines - May 15, 2013 Category: Consumer Health News Tags: Internal Medicine News Source Type: news

Chinese vs US Docs: Comparing Burnout and LifestyleChinese vs US Docs: Comparing Burnout and Lifestyle
Chinese and US physicians were asked the same questions in a survey about lifestyle and burnout. The differences are significant. Medscape Internal Medicine (Source: Medscape Today Headlines)
Source: Medscape Today Headlines - May 15, 2013 Category: Consumer Health News Tags: Internal Medicine Article Source Type: news

Topol on Using Smartphones for Complex Diagnostic ChallengesTopol on Using Smartphones for Complex Diagnostic Challenges
Eric J. Topol, MD, describes how smartphones and supercomputers will partner to help clinicians with challenging medical diagnoses and treatments. Medscape (Source: Medscape Today Headlines)
Source: Medscape Today Headlines - May 15, 2013 Category: Consumer Health News Tags: Internal Medicine Commentary Source Type: news

Elective delivery of twins at 37 weeks gestation decreases infant complications
Commentary on: Dodd J, Crowther C, Haslam R, et al.., for the Twins Timing of Birth Trial Group. Elective birth at 37 weeks of gestation versus standard care for women with an uncomplicated twin pregnancy at term: the Twins Timing of Birth Randomised Trial. BJOG 2012;119:964–74. Context In singleton pregnancies, offering elective delivery at or beyond term (40 weeks gestation) reduces perinatal mortality.1 2 Epidemiological data suggest that in twin pregnancies ‘term’ may be earlier than in singletons. Morbidity and mortality in twin pregnancies is the lowest in association with delivery at 36&n...
Source: Evidence-Based Medicine - May 15, 2013 Category: Internal Medicine Authors: Stock, S. J., Norman, J. E. Tags: Clinical trials (epidemiology), Epidemiologic studies, Pregnancy Therapeutics Source Type: research

Zinc supplementation for probable serious bacterial infection in early infancy may reduce the need for antibiotic change
Commentary on: Bhatnagar S, Wadhwa N, Aneja S, et al.. Zinc as adjunct treatment in infants aged between 7 and 120 days with probable serious bacterial infection: a randomised, double-blind, placebo-controlled trial. Lancet 2012;379:2072–8. Context It has now been over 15 years since the publication of the landmark study by Sazawal et al1 demonstrating the efficacy of zinc supplementation during an acute diarrheal episode in children under 5. Since then, dozens of clinical trials have been undertaken to further unravel the role of zinc supplementation to reduce under-5 morbidity and mortality. It is widely ...
Source: Evidence-Based Medicine - May 15, 2013 Category: Internal Medicine Authors: Larson, C. P. Tags: Neurogastroenterology, Epidemiologic studies, Immunology (including allergy), Pneumonia (infectious disease), Childhood nutrition, Pneumonia (respiratory medicine) Therapeutics Source Type: research

Early planned birth may reduce neonatal sepsis compared to expectant management following preterm premature rupture of the membranes close to term
Commentary on: van der Ham DP, Vijgen SM, Nijhuis JG, et al..; on behalf of the PPROMEXIL trial group. Induction of labor versus expectant management in women with preterm prelabor rupture of membranes between 34 and 37 weeks: a randomized controlled trial. PLoS Med 2012;9:e1001208. Context Prelabour rupture of the membranes (rupture of the membranes prior to the onset of labour) occurs in 20% of all births.1 When this occurs at term there is good evidence that early delivery is associated with a lower incidence of maternal infection and increased maternal satisfaction compared with expectant management.2 Preterm prel...
Source: Evidence-Based Medicine - May 15, 2013 Category: Internal Medicine Authors: Morris, J. Tags: Clinical trials (epidemiology), Pregnancy, Diabetes Therapeutics Source Type: research

A brief intervention by emergency department providers decreased 12 month alcohol use
Commentary on: D'Onofrio G, Fiellin DA, Pantalon MV, et al.. A brief intervention reduces hazardous and harmful drinking in emergency department patients. Ann Emerg Med 2012;60:181–92. Context Emergency department (ED) patients have a high prevalence of alcohol use problems making it potentially an opportune setting to intervene. Brief interventions for alcohol misuse have demonstrated efficacy in other medical settings, but within the ED it has been less clear.1 2 The study by D'Onofrio and colleagues provides additional insights into this question. This randomised controlled trial at a single urban academic ED eval...
Source: Evidence-Based Medicine - May 15, 2013 Category: Internal Medicine Authors: Mello, M. J., Longabaugh, R. Tags: Clinical trials (epidemiology), Alcohol-related disorders, Drugs misuse (including addiction), Screening (epidemiology), Screening (public health) Therapeutics Source Type: research

High-intensity interventions promote smoking cessation among hospitalized patients
Commentary on: Rigotti NA, Clair C, Munafò MR, et al.. Interventions for smoking cessation in hospitalised patients. Cochrane Database Syst Rev 2012;5:CD001837. Context Hospitalisation represents a potent ‘teachable moment’ for the delivery of smoking cessation interventions. Many smokers are hospitalised for tobacco-related diseases that personalise the risks of persistent smoking and thereby enhance motivation to quit and receptivity to tobacco cessation assistance. Most hospitals are smoke-free and many have adopted broad, smoke-free campus policies that further restrict smoking on hospital grounds, m...
Source: Evidence-Based Medicine - May 15, 2013 Category: Internal Medicine Authors: Ostroff, J. S. Tags: Medical management, Smoking and tobacco, Drugs: cardiovascular system, Unwanted effects / adverse reactions, Drugs misuse (including addiction), Health education, Smoking Prevention Source Type: research

Confirming the value of pulse oximetry screening for diagnosing critical congenital heart disease
Commentary on: Thangaratinam S, Brown K, Zamora J, et al.. Pulse oximetry screening for critical congenital heart defects in asymptomatic newborn babies: a systematic review and meta-analysis. Lancet 2012;379:2459–64. Context Thangaratinam and colleagues, studied the value of pulse oximetry screening of neonates for critical congenital heart disease (CCHD). CCHD is usually defined as a congenital heart disease (CHD) that requires treatment in the neonatal period to prevent death or severe morbidity; most of these neonates have ductus-dependent lesions. About 25–40% of children born with CHD have CCHD, and 10&nd...
Source: Evidence-Based Medicine - May 15, 2013 Category: Internal Medicine Authors: Hoffman, J. I. E. Tags: EBM Diagnosis, Epidemiologic studies, Genetics, Drugs: cardiovascular system, Hypertension, Radiology, Pulmonary hypertension, Clinical diagnostic tests, Radiology (diagnostics), Screening (epidemiology), Screening (public health) Source Type: research

Primary care-based screening, diagnosis and management of postpartum depression effective for improving symptoms
Commentary on: Yawn BP, Dietrich AJ, Wollan P, et al. In collaboration with the TRIPPD practices. TRIPPD: a Practice-Based Network Effectiveness Study of Postpartum Depression Screening and Management. Ann Fam Med 2012;10:320–9. Context Postpartum depression (PPD) is a debilitating mental health disorder that negatively affects maternal functioning and child outcomes. Prevalence rates demonstrate that up to 19.2% of women will develop a major or minor depressive episode within the first 3 months postpartum.1 Depression places the second greatest burden on the health of childbearing women worldwide. Despite the p...
Source: Evidence-Based Medicine - May 15, 2013 Category: Internal Medicine Authors: Boyd, R. C. Tags: EBM Quality improvement, General practice / family medicine, Nursing, Pregnancy, Child and adolescent psychiatry, Mood disorders (including depression), Screening (epidemiology), Screening (public health) Source Type: research

The cardiovascular risk of azithromycin was increased in a large observational cohort study, contradicting findings from prior randomised trials
Commentary on: Ray WA, Murray KT, Hall K, et al.. Azithromycin and the risk of cardiovascular death. N Engl J Med 2012;366:1881–90. Context Azithromycin, a widely used broad-spectrum macrolide antibiotic, belongs to the same class of antibiotics as erythromycin and clarithromycin, both of which have been associated with an increased risk of potentially lethal arrhythmias. Azithromycin has generally been viewed as ‘safe’ from a cardiovascular standpoint, but recently several reports of azithromycin-associated QT interval prolongation have been published. In an effort to ascertain whether azithromycin carri...
Source: Evidence-Based Medicine - May 15, 2013 Category: Internal Medicine Authors: Muhlestein, J. B. Tags: EBM Prognosis, Sexual transmitted infections (bacterial), Health policy, Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Drugs misuse (including addiction), Health service research, Health education Source Type: research

Initiation of long-acting reversible contraceptive methods (IUDs and implant) at pregnancy termination reduces repeat abortion
Commentary on: Cameron S, Glasier A, Chen Z. Effect of contraception provided at termination of pregnancy and incidence of subsequent termination of pregnancy. BJOG 2012;119:1074–80. Context Despite the availability of effective modern contraceptive methods, unplanned pregnancy continues to be a major problem worldwide. In 2008, the worldwide abortion rate was found to be 28/1000 women aged 15–44, unchanged from 2003 rates of 29/1000 women.1 Immediate initiation of long-acting reversible contraceptive (LARC) methods following pregnancy termination has been identified as an effective strategy to reduce repeat un...
Source: Evidence-Based Medicine - May 15, 2013 Category: Internal Medicine Authors: McNicholas, C., Peipert, J. F. Tags: EBM Prognosis, Contraception, Drugs: obstetrics and gynaecology, Pregnancy, Ethics Source Type: research

Lack of association between proton pump inhibitors and adverse events in patients taking clopidogrel and aspirin
Commentary on Douglas IJ, Evans SJ, Hingorani AD, et al.. Clopidogrel and interaction with proton pump inhibitors: comparison between cohort and within person study designs. BMJ 2012;345:e4388 Context Clopidogrel inhibits the P2Y12 platelet receptor and is used in patients with acute coronary syndromes or ischaemic stroke to prevent recurrent vascular events. Proton pump inhibitors (PPIs), however, have been shown to reduce the pharmacodynamic effect of clopidogrel upon platelet inhibition, and have been linked in retrospective studies to a higher rate of ischaemic outcomes in patients taking clopidogrel. Methods A total o...
Source: Evidence-Based Medicine - May 15, 2013 Category: Internal Medicine Authors: Waksman, R., Gaglia, M. A. Tags: Smoking and tobacco, Epidemiologic studies, Drugs: cardiovascular system, Stroke, Ischaemic heart disease, Health education, Smoking Aetiology Source Type: research

'We do not see the lens through which we look': screening mammography evidence and non-financial conflicts of interest
It has become clear that conflicts of interest can influence scientific judgement and reporting of research results in the medical literature.1 In this issue of EBM, Rasmussen et al2 studied citation of systematic reviews of breast cancer screening3–5 that found smaller benefits and greater harms than did prior reviews. They then compared how the reviews were cited by general versus specialty journals. In most papers citing the reviews, the key, perhaps controversial, findings regarding overdiagnosis and breast cancer mortality were not discussed. But in those papers that did describe those findings, papers published...
Source: Evidence-Based Medicine - May 15, 2013 Category: Internal Medicine Authors: Saitz, R. Tags: Epidemiologic studies, General practice / family medicine, Screening (oncology), Radiology, Clinical diagnostic tests, Radiology (diagnostics), Screening (epidemiology), Ethics, Screening (public health) Editorials Source Type: research

Citations of scientific results and conflicts of interest: the case of mammography screening
Conclusions Articles in specialty journals were more likely to explicitly reject results from the Cochrane reviews, and less likely to accept the results and methods, than articles in general medical journals. Several specialty journals are published by interest groups and some authors have vested interests in mammography screening. (Source: Evidence-Based Medicine)
Source: Evidence-Based Medicine - May 15, 2013 Category: Internal Medicine Authors: Rasmussen, K., Jorgensen, K. J., Gotzsche, P. C. Tags: Epidemiologic studies, Open access, Editor's choice, Screening (oncology), Radiology, Clinical diagnostic tests, Radiology (diagnostics), Screening (epidemiology), Ethics, Screening (public health) Original EBM Research Source Type: research

Medical apps for smartphones: lack of evidence undermines quality and safety
Increasing numbers of healthcare professionals are using smartphones and their associated applications (apps) in daily clinical care. While these medical apps hold great potential for improving clinical practice, little is known about the possible dangers associated with their use. Breaches of patient confidentiality, conflicts of interests and malfunctioning clinical decision-making apps could all negatively impact on patient care. We propose several strategies to enhance the development of evidence-based medical apps while retaining their open nature. The increasing use of medical apps calls for broader discussion across...
Source: Evidence-Based Medicine - May 15, 2013 Category: Internal Medicine Authors: Buijink, A. W. G., Visser, B. J., Marshall, L. Tags: Patients, Ethics, Legal and forensic medicine Perspective Source Type: research

Searching for the right evidence: how to answer your clinical questions using the 6S hierarchy
Asking and answering clinical questions during daily practice can be challenging and time consuming. Knowing the resources available to answer a specific clinical question can lead to a more efficient and effective search strategy and thus, to a more applicable answer based on the levels of evidence available. This primer reviews how to search for the right evidence using a specified hierarchy and provides examples of pre-appraised resources with corresponding websites to help with your search. Introduction The readers of our journal most likely have busy clinical, administrative and/or teaching roles. As such, time is of ...
Source: Evidence-Based Medicine - May 15, 2013 Category: Internal Medicine Authors: Windish, D. Tags: Patients, Editor's choice, General practice / family medicine Primer Source Type: research

What effect does breastfeeding have on coeliac disease? A systematic review update
Conclusions Our findings support previous published findings that breastfeeding seems to offer a protection against the development of CD in predisposed infants. Breastfeeding at time of gluten introduction is the most significant variable in reducing the risk. Timing of gluten introduction may also be a factor in the development of CD. (Source: Evidence-Based Medicine)
Source: Evidence-Based Medicine - May 15, 2013 Category: Internal Medicine Authors: Henriksson, C., Bostrom, A.-M., Wiklund, I. E. Tags: Childhood nutrition Systematic review Source Type: research

Oral egg immunotherapy is effective for desensitisation but not for inducing sustained tolerance in the majority of egg allergic children
Commentary on: Burks AW, Jones SM, Wood RA, et al.; Consortium of Food Allergy Research (CoFAR). Oral immunotherapy for treatment of egg allergy in children. N Engl J Med. 2012;367:233–43. Context Egg allergy is now one of the most common food allergies in infants and children in Australia, North America, the UK and Europe. Although the natural history of egg allergy is for tolerance and resolution in a significant portion of children, emerging trends suggest that this resolution may be less common and occur at an older age than previously believed. Egg and egg proteins are ubiquitous and strict avoidance is both dif...
Source: Evidence-Based Medicine - May 15, 2013 Category: Internal Medicine Authors: Campbell, D. E. Tags: Immunology (including allergy) Therapeutics Source Type: research

Intensive glucose control in patients with type 2 diabetes is associated with a reduction in albuminuria and may be associated with reduced end-stage renal disease
Commentary on: Coca SG, Ismail-Beigi F, Haq N, et al.. Role of intensive glucose control in development of renal end points in type 2 diabetes mellitus: systematic review and meta-analysis intensive glucose control in type 2 diabetes. Ann Intern Med 2012;172:761–9. Context Diabetic nephropathy is the commonest cause of end-stage renal disease (ESRD)1 making the prevention of its onset and progression, critically important. While epidemiological studies have linked hyperglycaemia to diabetic nephropathy, randomised controlled trials (RCTs) to date have reported the beneficial effects of intensive glycaemic control on ...
Source: Evidence-Based Medicine - May 15, 2013 Category: Internal Medicine Authors: Lo, C., Zoungas, S. Tags: Clinical trials (epidemiology), Epidemiologic studies, Renal medicine, Diabetes Therapeutics Source Type: research

Cervical pessary reduces spontaneous delivery before 34 weeks and adverse outcomes in pregnant women with a short cervix
Commentary on: Goya M, Pratcorona L, Merced C, et al. Pesario Cervical para Evitar Prematuridad (PECEP) Trial Group. Cervical pessary in pregnant women with a short cervix (PECEP): an open-label randomised controlled trial. Lancet 2012;379:1800–6. Context Prematurity prevention continues to be one of the biggest challenges in perinatal medicine. Most pregnancies complicated by preterm birth occur in gestations without any historical risk factors. The most effective therapeutic approach for the asymptomatic patient with a short cervix continues to evolve. For over 50 years, the cervical pessary has been used to t...
Source: Evidence-Based Medicine - May 15, 2013 Category: Internal Medicine Authors: Ludmir, J. Tags: Clinical trials (epidemiology), Pregnancy, Radiology, Clinical diagnostic tests, Radiology (diagnostics) Prevention Source Type: research

Lung cancer screening with low-dose CT: benefits and potential risks
Commentary on: Bach PB, Mirkin JN, Oliver TK, et al.. Benefits and harms of CT screening for lung cancer: a systematic review. JAMA 2012;307:2418–29. Context Lung cancer is the leading cause of cancer death worldwide.1 The majority of patients present with advanced disease and the current 5-year survival is only 15%.2 Previous research showed no mortality benefit to screening with chest radiography and sputum cytology. The recent results of the National Lung Screening Trial (NLST) are the first to show a significant reduction in lung cancer mortality with the use of low-dose CT (LDCT) in high risk individuals. The po...
Source: Evidence-Based Medicine - May 15, 2013 Category: Internal Medicine Authors: Tanner, N. T., Silvestri, G. A. Tags: Smoking and tobacco, Clinical trials (epidemiology), Epidemiologic studies, Stroke, Screening (oncology), Radiology, Clinical diagnostic tests, Radiology (diagnostics), Screening (epidemiology), Guidelines, Health education, Screening (public health), Smo Source Type: research

Hormone therapy not recommended for chronic disease prevention in menopausal women
Commentary on: Nelson HD, Walker M, Zakher B, et al.. Menopausal hormone therapy for the primary prevention of chronic conditions: a systematic review to update the US Preventive Services Task Force recommendations. Ann Intern Med 2012;157:104–13. Context In 2005, the US Preventive Services Task Force (USPSTF) updated its 2002 hormone replacement therapy recommendations, advising against the routine use of oestrogen and progestin (E+P) and unopposed oestrogen (E) to prevent chronic conditions in menopausal women. Menopausal hormone therapy (MHT) had been commonly prescribed to prevent conditions such as cardiovascula...
Source: Evidence-Based Medicine - May 15, 2013 Category: Internal Medicine Authors: Wenger, N. K. Tags: Pancreas and biliary tract, Epidemiologic studies, Drugs: cardiovascular system, Dementia, Stroke, Contraception, Drugs: obstetrics and gynaecology, Menopause (including HRT), Ischaemic heart disease, Venous thromboembolism, Memory disorders (psychiatry), Source Type: research

Cranberry-containing products are associated with a protective effect against urinary tract infections
Commentary on: Wang CH, Fang CC, Chen NC, et al.. Cranberry-containing products for prevention of urinary tract infections in susceptible populations: a systematic review and meta-analysis of randomized controlled trials. Arch Intern Med 2012;172:988–96. Context Urinary tract infection (UTI) is a common clinical problem that often recurs, leading to the institution of preventive measures for recurrent UTI (rUTI).1 2 Antimicrobial prophylaxis is highly effective, but risks adverse effects and induction of resistance.1 2 These considerations and widespread increases in antimicrobial resistance have intensified interest...
Source: Evidence-Based Medicine - May 15, 2013 Category: Internal Medicine Authors: Stapleton, A. E. Tags: Geriatric medicine, Clinical trials (epidemiology), Urinary tract infections, Drugs: CNS (not psychiatric), Pregnancy, Vulvovaginal disorders, Urinary tract infections Prevention Source Type: research

Appointment and medication non-adherence is associated with increased mortality in insulin-treated type 2 diabetes
Commentary on: Currie CJ, Peyrot M, Morgan CL, et al.. The impact of treatment noncompliance on mortality in people with type 2 diabetes. Diabetes Care 2012;35:1279–84. Context Diabetes increases the risk of death twofold; identifying novel modifiable risk factors could improve patient outcomes and focus healthcare spending in areas with the highest return. Non-adherence to prescribed medications and clinic appointments may be independent risk factors for excess mortality. Methods Currie and colleagues performed a database review of insulin-treated patients with type 2 diabetes who followed up for 6 months prior...
Source: Evidence-Based Medicine - May 15, 2013 Category: Internal Medicine Authors: Bundrick Harrison, L., Lingvay, I. Tags: EBM Prognosis, Smoking and tobacco, Epidemiologic studies, General practice / family medicine, Hypertension, Diabetes, Health education, Smoking Source Type: research

Opposite impacts of dietary versus supplemental calcium on cardiovascular health
Commentary on: Li K, Kaaks R, Linseisen J, et al.. Associations of dietary calcium intake and calcium supplementation with myocardial infarction and stroke risk and overall cardiovascular mortality in the Heidelberg cohort of the European prospective investigation into cancer and nutrition study (EPIC-Heidelberg). Heart 2012;98:920–5. Context Calcium supplementation is widely used to maintain bone health. Growing data suggests that calcium supplementation, but not dietary calcium intake, may harm cardiovascular (CV) health.1 2 There is no randomised controlled trial (RCT) that addressed CV events as primary endpoints...
Source: Evidence-Based Medicine - May 15, 2013 Category: Internal Medicine Authors: Guessous, I., Bochud, M. Tags: EBM Prognosis, Clinical trials (epidemiology), Epidemiologic studies, General practice / family medicine, Drugs: cardiovascular system, Stroke, Diet, Ischaemic heart disease Source Type: research

Exclusive bottle feeding of either formula or breast milk is associated with greater infant weight gain than exclusive breastfeeding, but findings may not reflect a causal effect of bottle feeding
This study adds a new twist, however: the consideration of bottle feeding, even among infants who receive breast milk via the bottle, rather than formula. Although formula and other nonhuman milk can be provided only by bottle, breast milk can be provided either via the breast or the bottle. Many breastfeeding mothers, particularly those who choose to or are obligated to return to work during breastfeeding, will pump their milk to provide bottled breast milk for their infants during their absence.... (Source: Evidence-Based Medicine)
Source: Evidence-Based Medicine - May 15, 2013 Category: Internal Medicine Authors: Kramer, M. S. Tags: EBM Prognosis, Clinical trials (epidemiology), Childhood nutrition, Occupational and environmental medicine Source Type: research

Long-term coffee consumption associated with reduced risk of total and cause-specific mortality
Commentary on: Freedman ND, Park Y, Abnet CC, Hollenbeck AR, Sinha R, et al.. Association of coffee drinking with total and cause-specific mortality. N Engl J Med 2012;366:1891–904. Context The effect of coffee consumption on health is being re-examined based on new evidence suggesting a beneficial effect of components in coffee other than caffeine,1–3 an effect that may be seen in the long term after the acute harmful effects of caffeine have disappeared. Supporting this idea, several recent well-designed cohort studies have found an inverse association between long-term coffee consumption and the risk of all-...
Source: Evidence-Based Medicine - May 15, 2013 Category: Internal Medicine Authors: Lopez-Garcia, E. Tags: EBM Aetiology, Smoking and tobacco, Epidemiologic studies, Drugs: cardiovascular system, Sleep disorders (neurology), Stroke, Hypertension, Diet, Sleep disorders, Sleep disorders (respiratory medicine), Health education, Smoking Source Type: research

Elective induction of labour is associated with decreased perinatal mortality and lower odds of caesarean section at 40 and 41 weeks
Commentary on: Stock SJ, Ferguson E, Duffy A, et al.. Outcomes of elective induction of labour compared with expectant management: population based study. BMJ 2012;344:e2838. Context Induction of labour can be utilised to intervene in a pregnancy when the risks of ongoing pregnancy outweigh that of intervention. Elective induction of labour is labour induction without a clear medical or obstetric indication. It is widely believed to increase caesarean delivery, posing unnecessary risks to mother and fetus.1 2 However, little objective information supports this conclusion, and a meta-analysis of randomised trials3 found tha...
Source: Evidence-Based Medicine - May 15, 2013 Category: Internal Medicine Authors: Caughey, A. B. Tags: EBM Aetiology, Epidemiologic studies, Hypertension, Pregnancy Source Type: research

Correction
This article presents independent research funded by the National Institute for Health Research (NIHR). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health." (Source: Evidence-Based Medicine)
Source: Evidence-Based Medicine - May 15, 2013 Category: Internal Medicine Tags: Correction Source Type: research

Milk, chocolate and Nobel prizes: potential role of lactose intolerance and chromosome 2
Two recent articles have demonstrated a strong positive correlation between population-level consumption of either chocolate1 or milk2 and the incidence rate of Nobel prizes. Messerli1 proposed the positive effect of chocolate flavonoids on cognitive functioning3 as the underlying biological mechanism. Extending Messerli's1 work, Laithwaite and Fuller2 reported a significant correlation between per capita milk consumption and Nobel prizes. Similar to flavonoids, vitamin D has been linked to enhanced cognitive functioning4 and Laithwaite and Fuller hypothesise that vitamin D in milk may be key to winning Nobel prizes.2 Inte...
Source: Evidence-Based Medicine - May 15, 2013 Category: Internal Medicine Authors: Loney, T., Nagelkerke, N. Tags: PostScript Source Type: research

Depression as a risk factor for adverse outcomes in coronary heart disease
Kenneth Freedland and Robert Carney argue that depression predicts coronary heart disease (CHD) but better methods are required to ascertain whether depression is a causal risk factor for CHD, which could help determine treatment strategies for CVD prevention. (Source: BMC Medicine)
Source: BMC Medicine - May 15, 2013 Category: Internal Medicine Authors: Kenneth FreedlandRobert Carney Source Type: research