The Journal of family practice
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Physicians have little evidentiary guidance for pharmacologic agent selection for atrial fibrillation (AF). ⋯ Although multiple antiarrhythmic agents had strong evidence of efficacy compared with control treatment for MSR, ibutilide/dofetilide and flecainide had particularly strong evidence of efficacy compared with control treatment for AF conversion. There is sparse and inconclusive evidence on direct agent comparisons and adverse event rates. Obtaining information regarding these relative efficacies should be a research priority.
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Lower extremity amputations are increasing among patients with diabetes in the United States. Evidence-based reviews suggest that many of these tragic events may be preventable within the framework of existing health care services. Known benefits for high-risk patients result from the coordination of proven care strategies, such as screening, prophylactic foot care, self-care management education, and protective footwear. Organizational changes in practice settings, including provider education, team coordination, patient registries, appointment systems, flowsheets, and chart reminders, improve both patient and provider participation in the behaviors required to interrupt the cascade of events leading to amputation.
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Multicenter Study Clinical Trial
Routine, single-item screening to identify abusive relationships in women.
Abusive relationships are associated with several demographic factors and many clinical problems in women. However, practices often do not screen for abuse. ⋯ Women in abusive relationships have many symptoms and functional limitations. However, symptoms and clinical problems provide insufficient clues for abuse. It is better just to ask. A single-item screening question appears adequate for this purpose.
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Randomized Controlled Trial Comparative Study Clinical Trial
Is either sotalol or amiodarone more effective than digoxin for converting patients with new-onset atrial fibrillation (AF) to sinus rhythm within 48 hours?