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Acupuncture is not as effective as infertility treatment in women with PCOS. 针灸治疗多囊卵巢综合征的效果不如不孕不育。
Evidence-Based Medicine Pub Date : 2017-12-01 Epub Date: 2017-10-22 DOI: 10.1136/ebmed-2017-110828
Liangzhi Xu, Xiaoyong Qiao
{"title":"Acupuncture is not as effective as infertility treatment in women with PCOS.","authors":"Liangzhi Xu, Xiaoyong Qiao","doi":"10.1136/ebmed-2017-110828","DOIUrl":"https://doi.org/10.1136/ebmed-2017-110828","url":null,"abstract":"Commentary on : Wu XK, Stener-Victorin E, Kuang HY, et al. Effect of acupuncture and clomiphene in Chinese women with polycystic ovary syndrome: a randomised clinical trial. JAMA 2017;317:2502–14.\u0000\u0000Ovulatory dysfunction is considered to be one of the major characteristics of polycystic ovary syndrome (PCOS), which affects 5%–10% of women of reproductive age and leads to 70%–80% of anovulatory infertility. Many ovulation induction treatments, including clomiphene citrate, letrozole, exogenous gonadotropin and laparoscopic ovarian drilling, have limited effectiveness, safety and negative side effects. Acupuncture has been used in eastern Asian countries for thousands of years, and the use of acupuncture in reproductive endocrinology and infertility is becoming popular in research and clinical practice. Several clinical and animal experimental studies indicate that acupuncture may improve ovulation frequency by improving endocrine profile and normalising insulin sensitivity.1 2 However, evidence is of very low quality. Many …","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmed-2017-110828","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35535242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 7
Early invasive strategy should be performed within 72 hours in high-risk patients with non-ST-elevation myocardial infarction. 非st段抬高型心肌梗死高危患者应在72小时内行早期有创策略。
Evidence-Based Medicine Pub Date : 2017-12-01 Epub Date: 2017-11-23 DOI: 10.1136/ebmed-2017-110848
Carlos Collet, Patrick W Serruys
{"title":"Early invasive strategy should be performed within 72 hours in high-risk patients with non-ST-elevation myocardial infarction.","authors":"Carlos Collet, Patrick W Serruys","doi":"10.1136/ebmed-2017-110848","DOIUrl":"https://doi.org/10.1136/ebmed-2017-110848","url":null,"abstract":"Commentary on : Jobs A, Mehta SR, Montalescot G, et al . Optimal timing of an invasive strategy in patients with non-ST-elevation acute coronary syndrome: a meta-analysis of randomised trials. Lancet 2017;390:737–46.\u0000\u0000The mainstay of treatment for patients presenting with non-ST-elevation acute coronary syndrome (NSTE-ACS) is medical therapy, early coronary angiography and revascularisation. A routine invasive strategy has been shown to reduce all-cause death and myocardial infarction  compared with a conservative approach at 5 years.1 Therefore, an early invasive strategy with intent to perform revascularisation is advocated in the 2014 American and European guidelines with a class I recommendation.2 3 While immediate angiography is recommended for extremely high-risk patients (eg, haemodynamic or electrical instability, persistent angina, heart failure or worsening mitral regurgitation), the optimal timing for an invasive approach in patients …","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmed-2017-110848","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35634300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
In patients with localised prostate cancer, active surveillance is associated with better sexual function, urinary symptoms and bowel symptoms. 在局部前列腺癌患者中，积极监测与更好的性功能、泌尿系统症状和肠道症状相关。
Evidence-Based Medicine Pub Date : 2017-12-01 Epub Date: 2017-11-10 DOI: 10.1136/ebmed-2017-110759
Roderick C N van den Bergh, Marie-Anne van Stam
{"title":"In patients with localised prostate cancer, active surveillance is associated with better sexual function, urinary symptoms and bowel symptoms.","authors":"Roderick C N van den Bergh, Marie-Anne van Stam","doi":"10.1136/ebmed-2017-110759","DOIUrl":"https://doi.org/10.1136/ebmed-2017-110759","url":null,"abstract":"Context Many patients with prostate cancer are diagnosed with low-risk disease only, for whom the benefit of surgery or radiation on life expectancy may be very limited, while still bringing the risk of side effects. 2 Therefore, patients with low-risk prostate cancer are currently offered the option of active surveillance. This strategy delays therapy with curative intent until progression occurs, or it may completely avoid radical treatment. As a result, in the treatment decision-making process of patients newly diagnosed with prostate cancer, up-to-date and preferably personalised information about the possible positive and negative effects of the treatment options is vital.","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmed-2017-110759","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35543510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prescribing antibiotics to hospitalised patients increases the risk of Clostridium difficile infection for the next bed occupant. 给住院病人开抗生素会增加下一个病人感染艰难梭菌的风险。
Evidence-Based Medicine Pub Date : 2017-12-01 Epub Date: 2017-10-25 DOI: 10.1136/ebmed-2017-110725
Nick Daneman
{"title":"Prescribing antibiotics to hospitalised patients increases the risk of <i>Clostridium difficile</i> infection for the next bed occupant.","authors":"Nick Daneman","doi":"10.1136/ebmed-2017-110725","DOIUrl":"https://doi.org/10.1136/ebmed-2017-110725","url":null,"abstract":"Commentary on: Freedberg DE, Salmasian H, Cohen B, et al . Receipt of antibiotics in hospitalized patients and risk for Clostridium difficile infection in subsequent patients who occupy the same bed . JAMA Intern Med 2016;176:1801–8.\u0000\u0000Patients are at heightened risk of Clostridium difficile- associated disease when they are exposed to both the organism and to antibiotic treatments, which deplete their normal, diverse, protective gastrointestinal flora. Both of these factors are prevalent in healthcare facilities, and thus C. difficile is the most common and most burdensome hospital-acquired pathogen.1 The hazards of antibiotic use may extend beyond the individual patient. As ward-level antibiotic use increases, so too does an individual patient’s risk of C. difficile infection, even when he or she has not directly received antibiotics.2 In this study, Freedberg et al aim to provide perhaps the most direct evidence of the indirect hazards of antibiotic use on the risk of C. difficile —by testing whether antibiotic receipt by a …","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmed-2017-110725","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35543619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cephalexin plus trimethoprim-sulfamethoxazole was not superior to cephalexin alone for the treatment of outpatient non-purulent cellulitis. 头孢氨苄联合甲氧苄氨苄磺胺甲恶唑治疗门诊非化脓性蜂窝织炎并不优于头孢氨苄单用。
Evidence-Based Medicine Pub Date : 2017-12-01 Epub Date: 2017-11-10 DOI: 10.1136/ebmed-2017-110796
Loren G Miller
{"title":"Cephalexin plus trimethoprim-sulfamethoxazole was not superior to cephalexin alone for the treatment of outpatient non-purulent cellulitis.","authors":"Loren G Miller","doi":"10.1136/ebmed-2017-110796","DOIUrl":"https://doi.org/10.1136/ebmed-2017-110796","url":null,"abstract":"Commentary on:  Moran GJ, Krishnadasan A, Mower WR, et al . Effect of cephalexin plus trimethoprim-sulfamethoxazole vs cephalexin alone on clinical cure of uncomplicated cellulitis: a randomised clinical trial. JAMA 2017;317:2088–96.\u0000\u0000Skin infections are one of the most common infections in ambulatory medicine. Yet, despite the high incidence of these infections, there remain questions about optimal treatment of cellulitis without abscess. Cellulitis without abscess is particularly challenging, as the aetiology of this infection remains relatively elusive. Studies employing molecular diagnostic techniques for bacteria from needle biopsies of cellulitis have failed to determine the aetiology of cellulitis without abscess. Current thinking is that cellulitis is usually caused by Group A Streptococcus and occasionally Staphylococcus aureus , possibly including methicillin-resistant S. aureus (MRSA). However, the relative contribution of these pathogens is unclear and the need to include anti-MRSA therapy as part of treatment for …","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmed-2017-110796","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35543507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prophylactic platelet transfusion does not reduce risk of clinical bleeding in adults with dengue and thrombocytopaenia. 预防性血小板输注不能降低成人登革热和血小板减少症患者的临床出血风险。
Evidence-Based Medicine Pub Date : 2017-12-01 Epub Date: 2017-11-02 DOI: 10.1136/ebmed-2017-110745
Muhammad Zaman Khan Assir, Fraz Ahmad
{"title":"Prophylactic platelet transfusion does not reduce risk of clinical bleeding in adults with dengue and thrombocytopaenia.","authors":"Muhammad Zaman Khan Assir,&nbsp;Fraz Ahmad","doi":"10.1136/ebmed-2017-110745","DOIUrl":"https://doi.org/10.1136/ebmed-2017-110745","url":null,"abstract":"Commentary on: Lye DC, Archuleta S, Syed-Omar SF, et al . Prophylactic platelet transfusion plus supportive care versus supportive care alone in adults with dengue and thrombocytopenia: a multicentre, open-label, randomised, superiority trial. Lancet 2017;389:1611–18.\u0000\u0000Dengue is the fastest growing vector-borne viral disease worldwide afflicting nearly 390 million people in 2010 with 96 million having clinically apparent infection.1 The clinical spectrum of dengue infection can vary from asymptomatic infection to life-threatening dengue shock syndrome.2 3 Thrombocytopaenia is a common manifestation of dengue infection. However, a correlation between platelet count and risk of clinical bleeding in dengue has not been established. A number of observational studies4 and a small randomised trial5 have shown lack of effectiveness of prophylactic platelet transfusion in preventing clinical bleeding in adults with dengue and thrombocytopaenia. This larger …","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmed-2017-110745","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35219005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
A meta-analysis of positive airway pressure treatment for cardiovascular prevention: why mix apples and pears? 正压通气治疗预防心血管疾病的荟萃分析:为什么要把苹果和梨混在一起?
Evidence-Based Medicine Pub Date : 2017-12-01 Epub Date: 2017-11-18 DOI: 10.1136/ebmed-2017-110835
Yüksel Peker, Patrick J Strollo
{"title":"A meta-analysis of positive airway pressure treatment for cardiovascular prevention: why mix apples and pears?","authors":"Yüksel Peker,&nbsp;Patrick J Strollo","doi":"10.1136/ebmed-2017-110835","DOIUrl":"https://doi.org/10.1136/ebmed-2017-110835","url":null,"abstract":"Commentary on : Yu J, Zhou Z, McEvoy RD, et al . Association of positive airway pressure with cardiovascular events and death in adults with sleep apnea: a systematic review and meta-analysis. JAMA 2017;318:156–66.\u0000\u0000Despite an increasing body of evidence supporting an independent association between sleep apnoea and cardiovascular outcomes, there is still a lack of convincing data to suggest that treating this disorder reduces the cardiovascular risk. Sleep apnoea may be either obstructive (OSA) or central (CSA), or of a combination of both types, especially in patients with concomitant cardiovascular disease (CVD). Randomised controlled trials (RCT) have shown that continuous positive airway pressure (CPAP) treatment reduces excessive daytime sleepiness and improves quality of life in sleepy patients with OSA.1 Randomisation of patients with this phenotype to no treatment has been considered unethical. Thus, the long-term RCTs during the last decade have been …","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmed-2017-110835","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35259175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Acute myocardial infarction can be ruled out with a single high-sensitivity cardiac troponin T level. 急性心肌梗死可以排除单一的高灵敏度心肌肌钙蛋白T水平。
Evidence-Based Medicine Pub Date : 2017-12-01 Epub Date: 2017-09-18 DOI: 10.1136/ebmed-2017-110812
Martin J Holzmann
{"title":"Acute myocardial infarction can be ruled out with a single high-sensitivity cardiac troponin T level.","authors":"Martin J Holzmann","doi":"10.1136/ebmed-2017-110812","DOIUrl":"https://doi.org/10.1136/ebmed-2017-110812","url":null,"abstract":"Commentary on: Pickering JW, Than P, Cullen L, et al . Rapid rule-out of acute myocardial infarction with a single high-sensitivity cardiac troponin T measurement below the limit of detection. Ann Intern Med  2017;166:715–24.\u0000\u0000Historically, it has been regarded that at least two measurements of cardiac biomarkers, with 6 hours in between, are needed in order to rule out acute myocardial infarction (AMI). With the introduction of high-sensitivity cardiac troponin (hs-cTn) assays, the time it takes to detect signs of myocyte necrosis has shortened considerably.1 In an observational cohort study published in 2014, it was found that the risk of AMI within 30 days was 0.2% if the first high-sensitivity cardiac troponin T (hs-cTnT) measurement was <5 ng/L.2 The authors suggested that it was safe to discharge all patients with chest pain with a non-ischaemic ECG, if the first …","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmed-2017-110812","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35421719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Haem iron and nitrate/nitrite account for much of the mortality increase associated with red meat consumption. 血红素铁和硝酸盐/亚硝酸盐是与食用红肉相关的死亡率增加的主要原因。
Evidence-Based Medicine Pub Date : 2017-10-01 Epub Date: 2017-08-16 DOI: 10.1136/ebmed-2017-110787
Sabine Rohrmann, Jakob Linseisen
{"title":"Haem iron and nitrate/nitrite account for much of the mortality increase associated with red meat consumption.","authors":"Sabine Rohrmann,&nbsp;Jakob Linseisen","doi":"10.1136/ebmed-2017-110787","DOIUrl":"https://doi.org/10.1136/ebmed-2017-110787","url":null,"abstract":"Commentary on: Etemadi, A, Sinha R, Ward MH, et al. Mortality from different causes associated with meat, heme iron, nitrates, and nitrites in the NIH-AARP Diet and Health Study: population based cohort study.  BMJ 2017;357:j1957.\u0000\u0000The International Agency for Research on Cancer categorised processed meat as carcinogenic to humans in 2015.1 High red and processed meat consumption is positively associated with risk of cardiovascular disease and type 2 diabetes as well as overall mortality.2 Usually the intake of processed red meat is found to be more strongly associated with disease outcomes than unprocessed red meat, which is thought to be due to preservation methods such as salting, curing and smoking, increasing the concentration of potentially hazardous substances in meat.3 \u0000\u0000In the US National Institutes of Health-American Association of Retired Persons (NIH-AARP) …","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmed-2017-110787","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35328649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Value of screening for and treating pre-diabetes is reduced by low test accuracy and indirect evidence of impact on patient important outcomes. 筛查和治疗糖尿病前期的价值因检测准确性低和间接证据对患者重要结局的影响而降低。
Evidence-Based Medicine Pub Date : 2017-10-01 Epub Date: 2017-07-22 DOI: 10.1136/ebmed-2017-110754
Neri A Alvarez-Villalobos, Rene Rodriguez-Gutierrez, Victor M Montori
{"title":"Value of screening for and treating pre-diabetes is reduced by low test accuracy and indirect evidence of impact on patient important outcomes.","authors":"Neri A Alvarez-Villalobos,&nbsp;Rene Rodriguez-Gutierrez,&nbsp;Victor M Montori","doi":"10.1136/ebmed-2017-110754","DOIUrl":"https://doi.org/10.1136/ebmed-2017-110754","url":null,"abstract":"Commentary on: Barry E, Roberts S, Oke J, et al . Efficacy and effectiveness of screen and treat policies in prevention of type 2 diabetes: systematic review and meta-analysis of screening tests and interventions. BMJ 2017;356:i6538.\u0000\u0000Type 2 diabetes is a major cause of morbidity and mortality. Hoping to reduce the burden of diabetes on people and societies, guidelines have recommended screening for hyperglycaemia in healthy population.1 These recommendations assume that early detection and intervention can prevent the morbimortality associated with type 2 diabetes and its complications.1 The systematic review by Barry et al sought to evaluate the accuracy of screening and the efficacy of early intervention (lifestyle or metformin) to prevent type 2 diabetes1.\u0000\u0000They conducted a rigorous systematic review of the published literature until June 2016. They then conducted two meta-analyses. The first one, a bivariate random-effects model meta-analysis, summarised …","PeriodicalId":12182,"journal":{"name":"Evidence-Based Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/ebmed-2017-110754","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35191232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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