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Dear Colleagues, As I had mentioned in one of my previous messages to the list that I bring out a monthly professional news letter called JSCN (for local circulation typed and stapled by me!) in which current research findings of interest to the health professionals are summarised. From this month I have included a section on Evidence based practice (joining this list gave me the inspiration!) in which I attempt to include studies providing evidence based replies to health problems in a question & answer format. I am sending the questions and the references where the answers can be found to the list as a peer review and for a few helpful comments (on journals to be covered or types of studies to be included in the future issues). If you are not interested or you have no time please do not read further and delete the message straight away. I apologise for the length of this message. Hoping that at least I will get a couple of useful responses. Cheers, What is the efficacy of different methods of treatment in the management of infertility? Efficacy of Superovulation and Intrauterine Insemination in the Treatment of Infertility. Guzick DS,Carson SA, Coutifaris C et al. N Engl J Med 1999;340:177-183. In patients with persistently active rheumatoid arthritis, is it beneficial and safe to add etanercept to a treatment regimen containing methotrexate? A Trial of Etanercept, a Recombinant Tumor Necrosis Factor Receptor:Fc Fusion Protein, in Patients with Rheumatoid Arthritis receiving Methotrexate. Weinblatt ME, Kremer JM, Bankhurst AD et al. N Engl J Med 1999;340:253-9. Is it possible to make the clinicians’ use of laboratory testing appropriate? A quality management intervention to improve clinical laboratory use in acute myocardial infarction. Isouard G. MJA 1999;170:11-14. What are the long term effects of in utero exposure to Zidivudine in uninfected children? Lack of Long-term Effects of In Utero Exposure to Zidovudine Among Uninfected Children Born to HIV-Infected Women. Culnane M, Fowler M, Lee SS et al. JAMA 1999;281:151-157. How effective are the chlorhexidine-siver sulfadiazine-impregnated central venous catheters in the prevention of catheter-related bloodstream infection? Efficacy of Antiseptic-Impregnated Central Venous Catheters in Preventing Catheter-Related Bloodstream Infection A Meta-Analysis. Veenstra DL, Saint S, Soha S, Lumley T, Sullivan SD. JAMA 1999;281:261-7. Is there a difference in the rates of catheter colonization and catheter-related bloodstream infection associated with catheters impregnated with either minocycline and rifampin or chlorhexidine and silver sulfadiazine? A comparison of Two Antimicrobial-Impregnated Central Venous Catheters. Darouiche RO, Raad II, Heard SO et al. N Engl J Med 1999;340:1-8. What is the efficacy of oral antibiotics in the initial empirical management of severe forms of urinary tract infection(UTI) in the hospital setting? Oral vs Intravenous Ciprofloxacin in the Initial Empirical Management of Severe Pyelonephritis or Complicated Urinary Tract Infections – A Prospective Randomized Clinical Trial. Mombelli G, Pezzoli R, Pinoja-Lutz G, Monotti R, Marone C, Franciolli M. Arch Intern Med 1999;159:53-58. Is there a difference between 5-mg and 10-mg loading doses of warfarin sodium in producing the desired therapeutic results? A Randomized Trial Comparing 5-mg and 10-mg Warfarin Loading Doses. Crowther MA, Ginsberg JB, Kearon C et al. Arch Intern Med 1999;159:46-48. Is there a difference in effectiveness between pre-operative and postoperative initiation of prophylaxis for deep vein thrombosis (DVT) with low-molecular-weight heparin (LMWH)? Preoperative vs Postoperative Initiation of Low-Molecular-Weight Heparin Prophylaxis Against Venous Thromboembolism in Patients Undergoing Elective Hip Replacement. Hull RD, Brant RF, Pineo GF, Stein PD, Raskob GE, Valentine KA. Arch Intern Med 1999;159:137-141. Is there a simple diagnostic algorithm that will provide a non-invasive diagnosis in outpatients with suspected venous thromboembolism? Non-invasive diagnosis of venous thromboembolism in outpatients. Perrier A, Desmarais S, Miron MJ et al. Lancet 1999;353:190-95. Is there a survival benefit of a ß1 selective adrenoceptor blocker (bisoprolol) in patients with heart failure? The Cardiac Insufficiency Bisoprolol Study II (CIBIS-II): a randomised trial. CIBIS-II Investigators and Committees. Lancet 1999;353:9-13. Does prophylactic mastectomy reduce the incidence of breast cancer in women with a high risk of breast cancer on the basis of family history? Efficacy of Bilateral Prophylactic Mastectomy in Women with a Family History of Breast Cancer. Hartmann LC, Schaid DJ, Woods JE et al. N Engl J Med 1999;340:77-84. Does the addition of Ipratropium Bromide to albuterol sulfate improve the pulmonary function as compared to albuterol alone in the treatment of COPD? For COPD a Combination of Ipratropium Bromide and Albuterol Sulfate Is More Effective than Albuterol Base. Campbell S. Arch Intern Med 1999;159:156-160. Bye for now, Badri Dr.P.Badrinath M.D.,M.Phil.,(Epid) PhD(Cantab) Assistant Professor and Epidemiologist, Department of Community Medicine, UAE University, PO Box 17666, Al Ain, United Arab Emirates. Tel: 00 971 3 5039 652 Fax: 00 971 3 672022. [log in to unmask] [log in to unmask] ______________________________________________________ Get Your Private, Free Email at http://www.hotmail.com %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%