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Don’t prescribe testosterone to men with erectile dysfunction who have normal testosterone levels
Choosing Wisely Canada
Canadian Urological Association - Canadian Medical Association - University of Toronto
While testosterone treatment may increase sexual interest, there appears to be no significant influence on erectile function in men with normal testosterone levels.
ver más ... 2014Don’t order serum testosterone in men without symptoms of hypogonadism
Choosing Wisely Canada
Canadian Urological Association - Canadian Medical Association - University of Toronto
In the evaluation of men with erectile dysfunction, testosterone should only be ordered if there are signs and/or symptoms of hypogonadism.
ver más ... 2014Don’t order a routine bone scan and CT scan of the pelvis in men with low-risk prostate cancer
Choosing Wisely Canada
Canadian Urological Association - Canadian Medical Association - University of Toronto
Low-risk patients (defined by D’Amico criteria and National Comprehensive Cancer Network guidelines) are unlikely to have metastatic disease. Accordingly, imaging is generally unnecessary in patients with newly diagnosed prostate cancer who have a PSA <20.0 ng/mL and a Gleason score 6 or less unless the patient’s history or clinical examination suggests distant disease. Metastases are much more likely in high-grade disease that is characterized by fast and aggressive growth into ...
ver más ... 2014Don’t routinely use plasma or prothrombin complex concentrates for non-emergent reversal of vitamin K antagonists
Choosing Wisely Canada
Canadian Society for Transfusion Medicine - Canadian Medical Association - University of Toronto
Patients requiring non-emergent reversal of warfarin can often be treated with vitamin K or by discontinuing the warfarin therapy. Prothrombin complex concentrates should only be used for patients with serious bleeding or for those who need urgent surgery. Plasma should only be used in this setting if prothrombin complex concentrates are not available or are contraindicated.
ver más ... 2014Don’t routinely transfuse platelets for patients with chemotherapy-induced thrombocytopenia if the platelet count is greater than 10 X 109/L in the absence of bleeding
Choosing Wisely Canada
Canadian Society for Transfusion Medicine - Canadian Medical Association - University of Toronto
A platelet count of 10 X 109/L or greater usually provides adequate hemostasis. Platelet transfusions are associated with adverse events and risks. Considerations in the decision to transfuse platelets include the cause of the thrombocytopenia, comorbid conditions, symptoms of bleeding, risk factors for bleeding, and the need to perform an invasive procedure.
ver más ... 2014