What to Add When Methotrexate Fails in Rheumatoid Arthritis Patients
Allan S. Brett, MD
Patricia Anne Kritek, MD, EdM
Metformin vs. Glipizide for Patients with Diabetes and Coronary Disease
Metformin was associated with better cardiovascular outcomes.
Considering CRP Concentration Improves Diagnosis of Pneumonia
Low C-reactive protein levels helped rule out pneumonia.
Steroid Injection Is Effective for Some Patients with Morton Neuroma
But the durability of the effect is unclear.
Fundoplication vs. Optimal Medical Management for Chronic GERD
In the long run, patients with gastroesophageal reflux disease experienced greater improvements with surgery.
TNF Inhibitors Are Associated with Higher Risk for Melanoma in Rheumatoid Arthritis Patients
Absolute risk was small, but relative risk was increased by 50% in patients treated with tumor necrosis factor inhibitors.
Immune deficiency states, such as immunosuppression for organ transplantation, are associated with elevated risk for malignant melanoma. Although use of tumor necrosis factor α (TNF) inhibitors (e.g., infliximab [Remicade]) raises risk for opportunistic infections, whether their use is associated with excess risk for melanoma is unclear. In this population-based cohort study from Sweden, investigators evaluated the association between TNF inhibitor use and melanoma in patients with rheumatoid arthritis (RA).
The American College of Physicians has issued guidance for clinicians.
The American College of Physicians (ACP) has issued a new publication on prostate cancer screening, focusing mainly on prostate-specific antigen (PSA) testing. The statement begins with a synopsis of four published guidelines — those of the U.S. Preventive Task Force, American Cancer Society, American Urologic Association, and American College of Preventive Medicine — and ends with two "Guidance Statements." Along the way, the authors briefly review the evidence for and against screening, and list ten talking points for use in discussions between clinicians and patients.
Intensive Glycemic Control and End-Stage Renal Disease in Type 2 Diabetes
One case of ESRD was prevented for every 430 intensively treated patients.
Can We Perform Fewer Head CTs in the Emergency Department?
Perhaps, but crafting a good decision rule for computed tomography isn't easy.