Dr. Sydney Burwell, Dean of Harvard Medical School 1956

My students are dismayed when I say to them "Half of what you are taught as medical students will in 10 years have been shown to be wrong.
And the trouble is, none of your teachers know which half."



Thursday, November 7, 2013

Reviews

Dilute versus full strength formula in exclusively formula-fed preterm or low birth weight infants.
There is evidence from three small, old trials at unclear risk of bias that use of dilute formula in preterm or low birth weight formula-fed infants leads to an important reduction in the time taken for these infants to attain an adequate energy intake. There was no evidence of important differences in feeding intolerance. The impact on serious gastrointestinal problems, including necrotising enterocolitis, was not reported. Further randomised trials are needed to confirm these results. Basuki F, Hadiati DR, Turner T, McDonald S, Hakimi M. Cochrane Database Syst Rev. 2013 Nov 5;11:CD007263. [Epub ahead of print] PMID: 24194466

Effect of epinephrine on survival after cardiac arrest: a systematic review and meta-analysis
Epinephrine use during cardiac arrest is not associated with improved survival to hospital discharge. Observational studies with a lower-risk for bias suggest that it may be associated with decreased survival. Patanwala A, Slack M, Martin J, Basken R, Nolan PE. Minerva Anestesiol. 2013 Nov 6. [Epub ahead of print] PMID: 24193240

The efficacy and effectiveness of continuous glucose monitoring during pregnancy: a systematic review
Current evidence on the efficacy of CGM on improving glycemic control during pregnancy as well as on the effectiveness on pregnancy outcome is limited to 2 RCTs with contradicting results. Evidence on the cost-effectiveness is lacking. Further proper RCTs on the effectiveness and cost-effectiveness of CGM in pregnancy are required before wide implementation in practice. Voormolen DN, Devries JH, Evers IM, Mol BW, Franx A. Obstet Gynecol Surv. 2013 Nov;68(11):753-63. PMID: 24193194

Tailored antiplatelet therapy and clinical adverse outcomes
In the study, personalised antiplatelet treatment for antiplatelet resistance was found to be associated with less occurrence of death or stent thrombosis and the less risk of total clinical adverse events than conventional treatment, without increasing the risk of bleeding complications. Li J, Jian Z, Song M, Guo W, Chen G, Lu W, Qian D, Ouyang J, Yu J, Hu H, Jin J, Wu X, Huang L. Heart. 2013 Nov 5. [Epub ahead of print] PMID: 24192977

A randomized trial of energy-restricted high-protein versus high-carbohydrate, low-fat diet in morbid obesity
The relative carbohydrate and protein content of the diet, when combined with intensive CBT, does not significantly affect attrition rate, weight loss and psychosocial outcome in patients with severe obesity. Evidence Updates

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