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Choosing Wisely ® : Things we do for no reason

Choosing Wisely ®: Things we do for no reason

There are three arguments against noncontrast head computed tomography before lumbar puncture in acute bacterial meningitis patients. First, very few patients herniate from lumbar puncture. Second, noncontrast head computed tomography is not a good test to rule out the possibility of future brain herniation. Third, unnecessary noncontrast head computed tomography can delay antibiotic administration and worsen prognosis. Evidence from two cohort studies indicates the importance of physical ...

Less Is More Collection - JAMA Network

JAMA Network

Retrospective, multicenter cohort study. The database used contains information on demographic characteristics, admission status, diagnosis codes, discharge status, and dated medication and procedure records. In this cohort study of 237,872 propensity score-matched adults aged 65 years or older, perioperative gabapentin use was associated with an increased risk of delirium, new antipsychotic use, and pneumonia among older patients after major surgery. Based on these findings and those of ...

Choosing Wisely ® : Things we do for no reason

Choosing Wisely

The pulmonary function test (PFT) is used to evaluate lung health by measuring air flow and volumes. They help confirm clinical diagnoses such as chronic obstructive pulmonary disease (COPD) and asthma and monitor response to treatment and disease progression.In developing spirometry, several studies in the last century identified differences in lung function between races that led to to the implementation of racial adjustment factors. The racial adjustment factor for PFTs is detrimental ...

NICE

NICE

Performing intracranial computed tomography before lumbar puncture in patients with suspected acute bacterial meningitis can identify patients at high risk for brain herniation and detect alternative diagnoses. There are three arguments against intracranial computed tomography before LP in patients with acute bacterial meningitis. First, very few patients suffer a puncture hernia. Second, intracranial CT scan is not a good test to rule out the possibility of future brain herniation. Third, ...

NICE

NICE

Refractory ascites is a common complication of cirrhosis of the liver. Build-up of fluid causes difficulty in breathing, fatigue, nausea, poor appetite, acid reflux, abdominal pain and infection. The committee was informed that the procedure has the potential to increase the pre-existing risk of bacterial peritonitis in people with refractory ascites in cirrhosis. Evidence on the safety of long-term tunnelled peritoneal drainage catheter insertion for refractory ascites in cirrhosis is limited ...