Tuesday, November 18th, 2014


Top 50 Healthy Recipes of 2014

Celebrate the new year with EatingWell’s best healthy recipes! Our top 50 healthy recipes of 2014 will help you plan your weekly menu and eat healthier in the new year. We’ve included healthy recipes featuring fresh vegetables and fruits from every season, lean protein and healthy whole grains. Try our Asparagus-Mushroom Mini Lasagnas to boost your vegetable intake, Napa Cabbage & Pork Stir-Fry with Peanuts for a weeknight dinner your family will love or Breakfast Blueberry-Oatmeal Cakes for an easy on-the-go breakfast. <strong><a href=”http://www.eatingwell.com/free_downloads/best_recipes_cookbook”>Download a Free Cookbook of Our TopRead More

5 Meditation Tips for People Who Can't Focus

Meditation is more than just a stress buster. New research shows it can help boost creativity; another review found it could reduce symptoms of anxiety and depression, and it could even improve decision making, in addition to a host of other health benefits. But how can you embark on a serene course of meditation when you can barely quiet your multitasking brain long enough to finish tasks at home or at work? Here, five tips from meditation guru Amit Sood, MD, professor of medicine at the Mayo Clinic and author of The Mayo Clinic GuideRead More

Can we explain medically unexplained symptoms?

Strategies for discontinuation of proton pump inhibitors: a systematic review

Purpose. Proton pump inhibitors (PPIs) are considered to be overprescribed. Consensus on how to attempt discontinuation is, however, lacking. We therefore conducted a systematic review of clinical studies on discontinuation of PPIs. Methods. Systematic review based on clinical studies investigating discontinuation strategies and discontinuation rates for users of antisecretory medication judged eligible for withdrawal. The databases Medline, Embase and Cochrane Library were searched to December 2013 using the terms antisecretory, anti-ulcer, PPI, acid suppressant, discontinuation, step-down, step down, cessation, tapering, withdrawal and withhold. Search terms were used either singularly orRead More

Bell’s palsy: a summary of current evidence and referral algorithm

Spontaneous idiopathic facial nerve (Bell’s) palsy leaves residual hemifacial weakness in 29% which is severe and disfiguring in over half of these cases. Acute medical management remains the best way to improve outcomes. Reconstructive surgery can improve long term disfigurement. However, acute and surgical options are time-dependent. As family practitioners see, on average, one case every 2 years, a summary of this condition based on common clinical questions may improve acute management and guide referral for those who need specialist input. We formulated a series of clinical questions likely toRead More

Effectiveness of behavioural weight loss interventions delivered in a primary care setting: a systematic review and meta-analysis

Background. Overweight and obesity have negative health effects. Primary care clinicians are best placed to intervene in weight management. Previous reviews of weight loss interventions have included studies from specialist settings. The aim of this review was to estimate the effect of behavioural interventions delivered in primary care on body weight in overweight and obese adults. Methods. The review included randomized controlled trials (RCTs) of behavioural interventions in obese or overweight adult participants in a primary care setting, with weight loss as the primary outcome, and a minimum of 12Read More

Multi-drug therapy in chronic condition multimorbidity: a systematic review

Background. Older populations often suffer from multimorbidity and guidelines for each condition are often associated with recommended drug therapy management. Yet, how different and specific multimorbidity is associated with number and type of multi-drug therapies in general populations is unknown. Aim. The aim of this systematic review was to synthesize the current evidence on patterns of multi-drug prescribing in family practice. Methods. A systematic review on six common chronic conditions: diabetes mellitus, cardiovascular disease, cerebrovascular disease, chronic obstructive pulmonary disease (COPD), osteoarthritis and depression was conducted, with a focus onRead More

Absolute cardiovascular risk and GP decision making in TIA and minor stroke

Background. Transient ischaemic attacks (TIA) and minor strokes (TIAMS) have the same pathophysiological mechanism as stroke and carry a high risk of recurrent ischaemic events. Diagnosis of TIAMS can be challenging and often occurs in general practice. Absolute cardiovascular risk (ACVR) is recommended as the basis for vascular risk management. Consideration of cardiovascular risk in TIAMS diagnosis has been recommended but its utility is not established. Objectives. Firstly, to document the ACVR of patients with incident TIAMS and with TIAMS-mimics. Secondly, to evaluate the utility of ACVR calculation in informingRead More

Alternative diagnoses in patients in whom the GP considered the diagnosis of pulmonary embolism

Introduction. Pulmonary embolism (PE) often presents with nonspecific symptoms and may be an easily missed diagnosis. When the differential diagnosis includes PE, an empirical list of frequently occurring alternative diagnoses could support the GP in diagnostic decision making. Objectives. To identify common alternative diagnoses in patients in whom the GP suspected PE but in whom PE could be ruled out. To investigate how the Wells clinical decision rule for PE combined with a point-of-care d-dimer test is associated with these alternative diagnoses. Methods. Secondary analysis of the Amsterdam Maastricht UtrechtRead More

Travel-associated disease among US residents visiting US GeoSentinel clinics after return from international travel

Background. US residents make 60 million international trips annually. Family practice providers need to be aware of travel-associated diseases affecting this growing mobile population. Objective. To describe demographics, travel characteristics and clinical diagnoses of US residents who present ill after international travel. Methods. Descriptive analysis of travel-associated morbidity and mortality among US travellers seeking care at 1 of the 22 US practices and clinics participating in the GeoSentinel Global Surveillance Network from January 2000 to December 2012. Results. Of the 9624 ill US travellers included in the analysis, 3656 (38%)Read More