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Treatment with budesonide is not recommended in patients with COVID-19, as there is no evidence that it improves the outcomes of hospitalization, death or need for mechanical ventilation compared to ...
NICE
NICE
COVID-19 is a respiratory viral infection in which, as a result of the pandemic in 2020, various treatments have been tested to improve the results in terms of hospitalization and death, fundamentally. This review includes two randomized trials testing 3,217 non-hospitalized people with mild COVID-19, comparing treatment with inhaled budesonide versus usual care. Most of the evidence was rated as low to moderate quality.
ver más ... 2021Treatment that markedly lowers glycated hemoglobin from <6.5% to <8.0% is not recommended in patients with early chronic kidney disease (stages 1-3).
Choosing Wisely Australia
Australian and New Zealand Society of Nephrology
Diabetes mellitus is associated with significant cardiovascular morbidity and mortality and is the leading cause of chronic kidney disease (CKD) worldwide. Evidence indicates that tight glycaemic control in diabetic patients results in clinically significant preservation of kidney function. As such, patients with stage 1–3 CKD stemming from type 1 or type 2 diabetes mellitus should aim to achieve a HbA1c target of approximately 6.5% to <8.0%. Caution is recommended against intensively ...
ver más ... 2021It is not recommended to put into a plaster cast the fractures of the fifth metatarsal, as they will heal just as quickly in a removable boot.
Choosing Wisely UK
Royal College of Emergency Medicine
Fractures of the base of the fifth metatarsal in association with an inversion injury of the ankle are avulsion fractures that occur at the insertion of the peroneus brevis tendon. They are usually treated symptomatically with a support bandage or cast, with or without crutches (depending on the mobility of the patients). Only one study (of low quality) has adequately compared the cast and the support bandage. This suggests that there is no difference in pain or time to bony union, but that ...
ver más ... 2021Do not give multiple daily doses of aminoglycoside antibiotics to patients with normal and stable kidney function as the risk of toxicity is less with a single daily dose
Choosing Wisely Australia
The Australian and New Zealand Society of Nephrology
Acute kidney injury is a well-known complication of aminoglycosides. Because efficacy of these antibiotics is concentration-dependent rather than time-dependent frequent doses should be avoided. For instance, once- and three-times daily aminoglycoside antibiotics appear to be equally effective in the treatment of pulmonary exacerbations of cystic fibrosis and to be less toxic to children’s kidneys. The use of extended-interval (once daily) dosing for aminoglycosides is also effective and safe ...
ver más ... 2021It is not recommended to prescribe aspirin therapy for primary prevention of cardiovascular disease in patients with stage 1-3 chronic kidney disease
Choosing Wisely Australia
The Australian and New Zealand Society of Nephrology
Chronic kidney disease is a well‐known independent cardiovascular risk factor. Evidence for anti‐platelet therapy indicates that low‐dose aspirin reduces the risk of cardiovascular disease (CVD) by 25–33%, especially in patients with established CVD or those at high risk. In patients with cronic kidney disease (CKD) potential benefits of low-dose aspirin therapy need to be carefully weighed against an increased risk of bleeding. A meta-analysis of serious vascular events and major ...
ver más ... 2021