Reviews

Randomized trial of metformin vs insulin in the management of gestational diabetes
Metformin was found to provide adequate glycemic control with lower mean glucose levels throughout the day, less weight gain and a lower frequency of neonatal hypoglycemia. Logistic regression analysis showed that gestational age at diagnosis and mean pretreatment glucose level were predictors of the need for supplemental insulin therapy in women initially treated with metformin. Evidence Updates

Long-term mortality after screening for colorectal cancer
The effect of screening with fecal occult-blood testing on colorectal-cancer mortality persists after 30 years but does not influence all-cause mortality. The sustained reduction in colorectal-cancer mortality supports the effect of polypectomy. Evidence Updates

Evaluation and Treatment of Tinnitus: Comparative Effectiveness [Internet]
There is low strength of evidence (SOE) indicating that cognitive behavioral therapy interventions improve tinnitus-specific quality of life relative to inactive controls. For pharmacological interventions, SOE is low for improvements to subjective loudness from neurotransmitter drugs versus placebo; insufficient for antidepressants, other drugs, and food supplements with respect to subjective loudness; and insufficient for all other outcomes. There is insufficient SOE to suggest that medical interventions improve outcomes relative to inactive controls; sleep and global quality of life were not evaluated for medical interventions. The SOE for the adverse effect of sedation in pharmacological studies was judged insufficient. Future research should address the substantial gaps identified for KQ1 and KQ3. NLM Bookshelf

Serum Inflammatory Markers in Obstructive Sleep Apnea: A Meta-Analysis
In this meta-analysis, the levels of systemic inflammatory markers were found to be higher in OSA patients compared to control subjects. Nadeem R, Molnar J, Madbouly EM, Nida M, Aggarwal S, Sajid H, Naseem J, Loomba R. J Clin Sleep Med. 2013 Oct 15;9(10):1003-1012. PMID: 24127144

Long-acting beta2-agonists for chronic obstructive pulmonary disease
Moderate-quality evidence from 26 studies showed that inhaled long-acting beta2-agonists are effective over the medium and long term for patients with moderate to severe COPD. Their use is associated with improved quality of life and reduced exacerbations, including those requiring hospitalisation. Overall, findings showed that inhaled LABAs did not significantly reduce mortality or serious adverse events. Kew KM, Mavergames C, Walters JA. Cochrane Database Syst Rev. 2013 Oct 15;10:CD010177. [Epub ahead of print] PMID: 24127118

Treatment of hospital-acquired pneumonia with linezolid or vancomycin: a systematic review and meta-analysis
Linezolid and vancomycin have similar efficacy and safety profiles. The high statistical power and the near-zero efficacy difference between both antibiotics demonstrates that no drug is superior for the treatment of hospital-acquired pneumonia. Kalil AC, Klompas M, Haynatzki G, Rupp ME. BMJ Open. 2013 Oct 14;3(10):e003912. PMID: 241270