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Less Is More Collection - JAMA Network

Tu et al.

Head computed tomography (CT) examinations are used in acute settings to exclude structural pathology for patients with various psychiatric presentations. Recommendations for neuroimaging in psychiatric illness vary and mostly address first episodes of psychosis. No current guidelines address specific and common psychiatric presentations such as hallucinations, delusions, and suicidal ideation. The evidence comes from a cross-sectional study that included 369 patients who underwent a head CT ...

Choosing Wisely UK

6753

Magnetic resonance is the technique of choice for people with epilepsy. People who have had a first seizure, have fully recovered, have no headache and have a normal neurological examination do not usually need a CT scan while in the emergency department. Instead, they should be offered an outpatient magnetic resonance scan. Early performance of this test is important for timely decision making. The diagnosis should be made as soon as possible, ideally no more than a 6-week wait. There may be ...

Choosing Wisely UK

British Society for Antimicrobial Chemotherapy

Studies reveal a high infection rate and a high antibiotic prescription rate during the last month of life in cancer patients. But there was no change in symptomatic improvement in more than half of the patients. A review of non beneficial treatments in hospital at the end of life determined that the administration of antibiotics, cardiovascular, digestive and endocrine treatments was not beneficial in dying patients in 11-75% (mean 38%). Also end of-life treatment is independently associated ...

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

Essencial Salud

Keeping unused peripheral venous catheters inserted increases the risk of potentially preventable complications such as local infections, bacteraemia, or phlebitis. Clinical practice guidelines recommend removing any catheter that is not being used as soon as possible. It is necessary to evaluate the need on a daily basis and remove them if they are not used, or as soon as signs of complications appear. In conclusion, it is not recommended to leave any peripheral catheter inserted that is not ...

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

Essencial Salud

In patients with heart failure, the studies carried out have not identified a benefit in terms of mortality, but a higher incidence of renal alterations and hyperkalemia. Therefore, the routine use of the combination of ACE inhibitors and ARBs in patients with heart failure is not recommended. In those selected patients who remain symptomatic with standard treatment despite good compliance and in whom aldosterone antagonists are not an option (due to intolerance or contraindication), combined ...