If you request Lexapro (escitalopram) for your patient, the PHC formulary requires a trial and failure or a contraindication to two formulary agents, one of which must be citalopram . Why? Is it just to make things difficult, or is there an actual sensible Continue reading
Author Archives: RMoore
Do intra-articular hyaluronate injections help knee OA?
Effective management of pain from OA of the knee can be frustrating, for patient and clinician alike. When NSAID’s and physical therapy prove ineffective, we often turn to intra-articular injections of steroids. If they don’t work, intra-articular hyaluronic Continue reading
Beware the use of NSAID’s after an MI
NSAID use is very common. Myocardial infarctions are very common. And the use of NSAID’s in patients with coronary artery disease is very common. But a study published last year in Circulation (May 25, 2011) offers a cautionary tale about Continue reading
Oral steroids added to antibiotics beneficial for chronic rhinosinusitis in children and adolescents
So many published studies spend large amounts of time and money to show tiny improvements in care and which have large NNT (number needed to treat to help one person). It is refreshing and important to note studies that unequivocally change Continue reading
Vertebral compression fractures: treat conservatively
Clinical Question
Is vertebroplasty better than usual care in decreasing pain in patients with vertebral compression fractures? Continue reading
Cost-effective treatment for onychomycosis
Onychomycosis is a very common condition leading patients to seek advice from their primary care clinician.
Systemic treatment is the most effective: oral terbenifine is off patent and very Continue reading
Massage improves function in patients with chronic low back pain
A randomized controlled trial published in the Annals of Internal Medicine comparing two techniques of massage therapy showed a significant short- and long-term improvement using either technique, compared to usual care. Continue reading
Tube feeding at the end of life: ethics and best practices
I attended a great CME on tube feeding at the end of life, on August 18, 2011, by Dr. Michael Rabow from UCSF. Here is a summary of the highlights:
While 90% of doctors think patients with advanced dementia benefit from tube feeds Continue reading
Intermittent inhaled corticosteroids effective for childhood asthma
This study shows a new way to treat a common problem, with less side effects.
From Daily POEM (Patient Oriented Evidence that Matters) part of Essential Evidence Plus service, which analyzes the medical literature to identify studies Continue reading
Reflections on Advance Care Planning in primary care and as a hospital specialty
Palliative Care is different from hospice, comfort care and DNR status: Palliative care (care where Advance Care Planning takes place) is an ongoing conversation in the context of a trusting relationship over time. This is the essence of true Continue reading