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Southeast Heights Teaching

Page history last edited by kmccalmont@salud.unm.edu 3 days, 18 hours ago

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Table of Contents


 

Monday Teaching

Teaching sessions are held on Mondays from 12:30 to 1:15 pm. All residents from morning or afternoon session should be present unless they have a conflicting clinical/residency obligation.

Please select a recent article from one of the sources below or you may present the evidence around diagnosis or management of a primary care topic.  

Presentations should be 15-20 minutes long with time for discussion afterward.

 

IDEAS FOR TOPICS

Evidence Alerts (McMaster and DynaMed-- register for free to receive alerts):  https://plus.mcmaster.ca/EvidenceAlerts/Default.aspx

ACP Journal Club (find journal on HSLIC website, through WorldCat search)-- select an article to review (includes commentary/analysis!)

POEMs from Essential Evidence Plus-- can sign up for email updates (subscription does cost $96/year)

AFP POEMS (Patient Oriented Evidence that Matters):  http://www.aafp.org/afp/viewRelatedDepartmentsByDepartment.htm?departmentId=111

Evidence Based Medicine Journal (through BMJ):  https://ebm-bmj-com.libproxy.unm.edu (log in if off site)

FPIN PURLS (Priority Updates from Research Literature):  http://www.mdedge.com/jfponline/purls

ACCESSSS:  https://plus.mcmaster.ca/ACCESSSS/Default.aspx?Page=1

 

Recommended format for presentation:

1. Discuss where you found the article and why it is relevant to your practice.

2. Present the findings of the article.

3. Lead the group through the Critical appraisal process-- discuss the quality of the evidence and whether it is applicable to your patient population.  Use the critical appraisal guides: 

Critical Appraisal-SYSTEMATIC REVIEW.docx 

 Critical appraisal of RCT.docx 

 Prognosis critical appraisal.pdf 

Critical appraisal-Cohort study design re Harm.pdf

 

Template for presentation with examples:

RCT: 

Resident Presentation format- RCT.docx

Resident Presentation - RCT.ppt

 

Systematic review:  

Resident Presentation format- Systematic review.docx

Resident Presentation - SR Example.ppt

 

Past & Upcoming Teaching Sessions

Date
Presenter Topic/Article title

Link to article and clinical pearl/conclusions

7/10/23  Angelo Tomedi  Intro to Monday teaching 

SEH presentation July2023.ppt  

SEH presentation July2023 slides -abbreviated.ppt -- this set just includes the database sites of pre-appraised articles and how to find them, and the checklist for critical appraisal

7/17/23 Yen Bui

Respiratory Syncytial Virus Prefusion F

Protein Vaccine in Older Adults

A single dose of the RSVPreF3 OA vaccine had an acceptable safety profile and prevented RSV-related acute respiratory infection and lower respiratory tract disease and severe RSV-related lower respiratory tract disease in adults 60 years of age or older, regardless of RSV subtype and the presence of underlying coexisting conditions.

nejmoa2209604.pdf

7/24/23 Eve Wiggins Comparison of amitriptyline supplemented with pregabalin, pregabalin supplemented with amitriptyline, and duloxetine supplemented with pregabalin for the treatment of diabetic peripheral neuropathic pain (OPTION-DM): a multi-centre, double-blind, randomised crossover trial 

To our knowledge, this was the largest and longest ever, head-to-head, crossover neuropathic pain trial. We showed that all three treatment pathways and monotherapies had similar analgesic efficacy. Combination treatment was well tolerated and led to improved pain relief in patients with suboptimal pain control with a monotherapy. 

DM-PainMeds.pdf

7/31/23 Owen Hamilton

Vaginal progesterone for preventing preterm birth and adverse perinatal outcomes in twin gestations: a systematic review and meta-analysis

Vaginal progesterone does not prevent preterm birth, nor does it improve perinatal outcomes in unselected twin gestations, but it appears to reduce the risk of preterm birth occurring at early gestational ages and of neonatal morbidity and mortality in twin gestations with a sonographic short cervix. However, more evidence is needed before recommending this intervention to this subset of patients. 

https://pubmed.ncbi.nlm.nih.gov/37196896/

8/7/23 Yara Khalifa Pharmacological treatments for generalized anxiety disorder: a systematic review and network meta-analysis 

To our knowledge, this is the largest contemporary review of pharmacological agents for the treatment of generalised anxiety disorder by use of network analysis. There are several effective treatment choices for generalised anxiety disorder across classes of medication. The failure of initial pharmacological therapy might not be a reason to abandon a pharmacological treatment strategy. 

Pharmacologic Treatment of Generalised Anxiety Disorder- SR.pdf

8/14/23 Whitney Peterson Efficacy and safety of once-daily oral semaglutide 25 mg and 50 mg compared with 14 mg in adults with type 2 diabetes (PIONEER PLUS): a multicentre, randomised, phase 3b trial 

Oral semaglutide 25 mg and 50 mg were superior to 14 mg in reducing HbA1c and bodyweight in adults with inadequately controlled type 2 diabetes. No new safety concerns were identified. 

Efficacy and safety of once-daily oral semaglutide.pdf

Resident Presentation - RCT(1).ppt

8/21/23 Matthew Lucero P2Y12 Inhibitor or Aspirin Monotherapy for Secondary Prevention for Coronary Events 

Given its superior efficacy and similar overall safety, P2Y12 inhibitor monotherapy might be preferred over aspirin monotherapy for long-term secondary prevention in patients with established CAD.

1-s2.0-S0735109723055936-main.pdf

8/28/23 Dustin Cochran

Opioid analgesia for acute low back pain and neck pain (the OPAL trial): a randomised placebo-controlled trial

 

Opioids should not be recommended for acute non-specific low back pain or neck pain given that we found no significant difference in pain severity compared with placebo. This finding calls for a change in the frequent use of opioids for these conditions. 

https://www.sciencedirect.com/science/article/pii/S014067362300404X

SEH Monday Teaching DustinCochran.pptx

9/11/23 Eliana Otero-Bell Evaluation of co-testing with cytology and human papillomavirus testing in cervical screening 

Resident Presentation - ELOB 9 11 23.pptx  

Evaluation of Co-Testing with Cytology and HPV Testing In Cervical Screening .pdf

9/18/23 Angelo Tomedi CVD Prevention 

Clopidogrel is preferable to aspirin for (chronic) secondary prevention in stroke patients.  Antiplatelet drugs for secondary prevention in patients with ischemic stroke.pdf

Colchicine reduces CVD events when added to other evidence-based interventions for secondary prevention in CAD patients.  Colchicine in CVD prevention.pdf

SEH Presentation Sept2023- seconadry prevention of stroke and CVD.ppt
10/2/23 Claire Sava

Cabotegravir for HIV Prevention in Cisgender Men and Transgender Women

CAB-LA was superior to daily oral TDF-FTC in preventing HIV infection among MSM and transgender women. Strategies are needed to prevent INSTI resistance in cases of CAB-LA PrEP failure. 

https://pubmed.ncbi.nlm.nih.gov/34379922/

PrEP- RCT.pptx

10/9/23 Kerry Zimdars Chlorthalidone vs. Hydrochlorothiazide for Hypertension-- Cardiovascular Events 

In this large pragmatic trial of thiazide diuretics at doses commonly used in clinical practice, patients who received chlorthalidone did not have a lower occurrence of major cardiovascular outcome events or non–cancer-related deaths than patients who received hydrochlorothiazide. 

https://www.nejm.org/doi/10.1056/NEJMoa2212270?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed

10/16/23 Yen Bui Effects of therapeutic interventions on pain due to plantar fasciitis: A systematic review and meta-analysis 

• Different therapeutic interventions resulted in being effective treatments for pain when compared to the control in the short term. In the medium and long term, only extracorporeal shock wave therapy was effective for improving pain when compared to the control.

• In the medium term, extracorporeal shock wave therapy was effective for improving pain when compared to corticosteroid injection. In addition, plantar fascia stretching was effective for improving pain when compared to muscle stretching.

• In the long term, there was no superiority when two different interventions were compared. 

Effects of therapeutic interventions on pain due to plantar fasciitis_ A systematic review and m.pdf

10/23/23 Owen Hamilton

Esketamine Nasal Spray versus Quetiapine for Treatment-Resistant Depression

In patients with treatment-resistant depression, esketamine nasal spray plus an SSRI or SNRI was superior to extended-release quetiapine plus an SSRI or SNRI with respect to remission at week 8.  

https://pubmed.ncbi.nlm.nih.gov/37792613/

Juniper Psychiatry provides ketamine treatment:  https://www.juniperpsychiatry.com/

10/30/23  Amanda Nguyen
Oral emergency contraception with levonorgestrel plus piroxicam: a randomised double-blind placebo-controlled trial 

Oral piroxicam 40 mg co-administered with levonorgestrel improved efficacy of EC in our study. Piroxicam co-administration could be considered clinically where levonorgestrel EC is the option of choice. 

L_P.pdf

11/6/23  Hannah Udell 

The proportions of term or late preterm births after exposure to early antenatal corticosteroids, and outcomes: systematic review and meta-analysis of 1.6 million infants

About 40% of infants exposed to early antenatal corticosteroids were born at term, with associated adverse short term and long term outcomes (low or very low certainty), highlighting the need for caution when considering antenatal corticosteroids.

https://pubmed.ncbi.nlm.nih.gov/37532269/

Steroid pregnancy article.pptx

11/27/23 Carlos Vargas A Systematic Review and Meta-Analysis on Effectiveness of Mineralocorticoid Receptor Antagonists in Reducing the Risk of Atrial Fibrillation 

Our meta-analysis concludes that MRAs reduce the risk of development of AF overall, with consistent effects in new-onset and recurrent AF. 

A systematic review and meta-analysis on effectiveness of minteralocorticoid receptor antagonits.pdf

MRAs reduce AF occurrence vs non-MRAs.pptx

ACP Journal Club In adults MRAs reduce AF occurrence v -non-MRAs.pdf

12/4/23 Angelo Tomedi
Cardiovascular and kidney outcomes with finerenone in patients with type 2 diabetes and chronic kidney disease: the FIDELITY pooled analysis

For patients with type 2 diabetes who have CKD and albuminuria ≥30 mg/day despite an ACEi or ARB, and an SGLT2 inhibitor (or if an SGLT2 inhibitor is not tolerated), treatment with the MRA finerenone can be added to further reduce CV and kidney events (if patient has a serum potassium ≤5 mEq/L and eGFR ≥25)

Cardiovascular and kidney outcomes with finerenone.pdf

Finerenone.ppt

12/11/23  Matthew Lucero

App-Based Interventions for Moderate to Severe Depression

These findings underscore the efficacy of mobile app interventions for moderate and severe depression both as standalone interventions and adjuncts to conventional treatments and provide confidence that refining the design of intervention programs can further enhance their effectiveness.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10660171/#note-ZOI231285-1-s

Also consider apps: Headspace, Calm

12/18/23 Yara Khalifa Efficacy and safety of osteopathic manipulative treatment: an overview of systematic reviews

Based on the currently available SRs and MAs, promising evidence suggests the possible effectiveness of OMT for musculoskeletal disorders. Limited and inconclusive evidence occurs for pediatric conditions, primary headache and IBS. Further well conducted SRs and MAs are needed to confirm and extend the efficacy and safety of OMT.

Efficacy and safety of OMT.pdf

1/8/24  Owen Hamilton  Strategies to Increase Cervical Cancer Screening With Mailed Human Papillomavirus Self-Sampling Kits 

Within a US health care system, direct-mail self-sampling increased cervical cancer screening by more than 14% in individuals who were due or overdue for cervical cancer screening. The opt-in approach minimally increased screening. To increase screening adherence, systems implementing HPV self-sampling should prioritize direct-mail outreach for individuals who are due or overdue for screening. For individuals with unknown screening history, testing alternative outreach approaches and additional efforts to document screening history are warranted. 

jama_winer_2023_oi_230128_1700158787.25616.pdf

1/15/24 Eliana Otero-Bell

Sunscreen Application, Safety, and Sun Protection: The Evidence


Our review revealed that the level of evidence supporting recommendations for the use of sunscreens and other sun-protection methods varies from fair to good, as assessed using the CTFPHC’s GRADE system.

https://journals-sagepub-com.libproxy.unm.edu/doi/epub/10.1177/1203475419856611

1/22/24 Diandra Little Dog Low-dose ketamine versus morphine in the treatment of acute pain in the emergency department: A meta-analysis of 15 randomized controlled trials 

Ketamine had better analgesic effects in the early stages after treatment, while morphine maintained more durable effects. Compared with morphine, ketamine had a lower incidence of adverse events requiring intervention. The results of subgroup analysis showed that intravenous administration of ketamine was more effective than intranasal administration. 

Low dose ketamine vs morphine for acute pain in the ED article.pdf

Low-dose ketamine versus morphine Diandra 1_22_24.pptx

1/29/24 Eve Wiggins Anti-convulsants in the treatment of low back pain and lumbar radicular pain: a systematic review and meta-analysis

There is moderate- to high-quality evidence that anticonvulsants are ineffective for treatment of low back pain or lumbar radicular pain. There is high-quality evidence that gabapentinoids have a higher risk for adverse events. 

Gabapentin_BackPain_2018.pdf

Wiggins-EBM presentation-012924.ppt

3/11/24 Whitney Peterson Comparative Effectiveness of Multiple Different First-Line Treatment Regimens for Helicobacter pylori Infection: A Network Meta-analysis 

For first-line empiric treatment of H pylori infection, vonoprazan triple therapy and reverse hybrid therapy achieved high eradication rates of >90%. Levofloxacin triple therapy achieved the highest eradication rates in Western countries. Standard triple therapy was the least efficacious regimen in this network meta-analysis. 

H pylori EBM article.pdf

Resident Presentation H pylori.ppt

3/18/24 Dustin Cochran

Effect of exercise for depression: systematic review and network meta-analysis of randomised controlled trials

Exercise is an effective treatment for depression, with walking or jogging, yoga, and strength training more effective than other exercises, particularly when intense. Yoga and strength training were well tolerated compared with other treatments. Exercise appeared equally effective for people with and without comorbidities and with different baseline levels of depression. To mitigate expectancy effects, future studies could aim to blind participants and staff. These forms of exercise could be considered alongside psychotherapy and antidepressants as core treatments for depression.

https://www.bmj.com/content/384/bmj-2023-075847.long

3/25/24 Amanda Nguyen Comparing aspirin 75 to 81 mg vs 150 to 162 mgfor prevention of preterm preeclampsia: systematic review and meta-analysis

When initiated in the first trimester of pregnancy, an aspirin dosage of 150 to 162 mg daily was associated with a lower risk of preterm PE than an aspirin dosage of 75 to 81 mg daily. However, the lack of large, high-quality studies limited the clinical scope of the current results taken alone.

ASA162.pdf

4/1/24  Claire Sava     
4/8/24  Yara Khalifa     
4/15/24  Yen Bui     
4/22/24  Matthew Lucero     
4/29/24 Lily McKoy-Drake    
5/6/24  Diandra Little Dog     
5/13/24 Eve Wiggins    
5/20/24 Owen Hamilton    
       
       
       

 

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