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Choosing Wisely ® : Things we do for no reason

Choosing Wisely ® : Things we do for no reason

Reflux precautions—such as upright positioning after feeding or elevating the head of the crib—should not be routinely taught to caregivers of asymptomatic infants. While often offered during hospital discharge or outpatient visits with good intentions, these practices lack evidence of clinical benefit in infants who do not display signs of gastroesophageal reflux disease (GERD). A review of the current literature reveals no clear evidence that these precautions reduce the incidence of ...

Choosing Wisely ® : Things we do for no reason

Choosing Wisely ® : Things we do for no reason

Avoiding intravenous iodinated contrast in patients with chronic kidney disease (CKD) has long been a common practice due to concern over contrast-associated acute kidney injury (CA-AKI). However, recent high-quality observational studies challenge this routine avoidance, especially in patients with mild to moderate CKD (eGFR >30 mL/min/1.73 m²). These studies consistently show no significant increase in AKI rates among those receiving contrast compared to matched controls who did not, ...

Choosing Wisely ® : Things we do for no reason

Choosing Wisely ® : Things we do for no reason

In immunocompetent patients with acute uncomplicated diverticulitis, routine antibiotic use does not improve clinical outcomes and may lead to unnecessary harms. The traditional practice of prescribing empiric antibiotics was based on the assumption that the underlying inflammation was driven by active bacterial infection. However, a growing body of evidence has challenged this rationale. Randomized controlled trials such as AVOD (2012) and DIABOLO (2017) have shown no significant differences ...

Essencial: Afegint valor a la pràctica clínica [Essencial: Adding value to the clinical practice]

Essencial Salut

In people with mild or moderate knee osteoarthritis, knee arthroplasty should not be offered as a first-line treatment. Current scientific evidence and numerous clinical guidelines strongly support prioritising conservative interventions such as structured physical exercise, patient education, weight loss, and symptomatic pharmacological treatment. These approaches have shown effectiveness in reducing pain and improving function, with a considerably better safety profile than surgery. Knee ...

Essencial: Afegint valor a la pràctica clínica [Essencial: Adding value to the clinical practice]

Essencial Salut

In patients with symptoms suggestive of knee osteoarthritis, diagnosis should be primarily clinical, with plain radiography used when imaging is required. Routine use of magnetic resonance imaging (MRI) is not justified, as it does not improve diagnostic accuracy or health outcomes, may delay appropriate treatment, and entails unnecessary costs. MRI should be reserved for atypical clinical presentations or when alternative diagnoses are suspected.re