Shared by Drs. Shari Fallis, Karen Louie, and Veronica Tomcej The Edmonton O-day’min Primary Care Network (EOPCN) Green for Health Committee has been working on a Green Healthcare Toolkit project for Alberta primary care providers, supported by grant funding from the Northern Alberta Academic Family Medicine Fund. This initiative provides practical tips to address ways…Read More
Important Info – ALBERTA ANNOUNCES FUNDING FOR EXTENDED RELEASE INJECTABLE BUPRENORPHINE:
ALBERTA ANNOUNCES FUNDING FOR EXTENDED RELEASE INJECTABLE BUPRENORPHINE: Because supporting information and resources on administering injectable buprenorphine is not yet readily available, the following information on injectable buprenorphine, also known as SublocadeTM, can be found at the following links: Evidence for use Instruction for administration Product Monograph Please note, the ACFP has no affiliation with…Read More
#271 – Be still my quivering heart: alcohol and atrial fibrillation
Clinical Question: Does advising patients to abstain from alcohol prevent atrial fibrillation recurrence? Bottom Line: Observational studies consistently report a doseresponse association between alcohol and new onset atrial fibrillation. Based on 1 randomized controlled trial (RCT) of “regular drinkers” with paroxysmal atrial fibrillation, recurrence of atrial fibrillation happened in ~50% who abstain compared to ~70% who…Read More
TFP #267 – Serology, Serology: How Accurate and Prevalent Art Thou?
Clinical Question: What is the role of serology testing in the COVID-19 pandemic? Bottom Line: IgM and IgG antibodies may reveal an individual’s recent (after ~2 weeks) exposure to COVID-19. How long serology remains positive and whether antibodies confer immunity to subsequent infection is unknown. Many different tests exist, each with different accuracy. Current evidence…Read More
TFP #266 – Exercise-induced osteoarthritis: Running into problems?
Clinical Question: Does running increase the risk of developing osteoarthritis? Bottom Line: Based on low-quality observational data, running likely does not increase the risk of developing osteoarthritis, except possibly in elite athletes. Additionally, recreational running may be associated with lowering the risk of knee osteoarthritis. Exercise is one of the most effective treatments for reducing…Read More
TFP #265 – “Does baby know best?”: Benefits and harms of baby-led weaning for transitioning to solid foods
Clinical Question: What impact does baby-led weaning have on infant growth, iron intake, and choking? Bottom Line: Transitioning infants to solid foods using a baby-led weaning approach (with parental education) results in up to 0.7kg less weight gain at 12 months than traditional spoon feeding. This is of unknown clinical significance. There is no difference in…Read More
TFP #264 – From theory to reality: ACEi, ARB, and COVID-19
Clinical Question: Do angiotensin converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARB) increase the risk of catching, or severity of infection with, COVID-19? Bottom Line: Despite initial theoretical suggestions that ACEi and ARB are harmful, four observational studies have since found no association between COVID-19 infection or severity of disease and ACEi/ARB. One cohort study with…Read More
TFP #263 – Finding COVID – How Good is the Test to Detect it?
Clinical Question: What is the chance of obtaining an incorrect result with the polymerase chain reaction (PCR) test for COVID-19? Bottom Line: If the PCR COVID-19 test is positive you have COVID-19 (specificity ~100%). Small Canadian studies suggest the test will detect COVID-19 ~80-90% of the time (sensitivity), although estimates range from ~50%-90%. Collection technique, anatomical sample…Read More
TFP #262 – Who let the Gout Out? Targeting Uric Acid Levels in Treating Gout
Clinical Question: To prevent gout recurrence, should we dose urate lowering therapies (like allopurinol) to target uric acid levels? Bottom Line: Best evidence finds that increasing doses of allopurinol to achieve a specific serum urate target (example <360 μmol/L) does not reduce gout flares, pain, or function, compared to standard allopurinol dosing. Febuxostat increases cardiovascular and…Read More
TFP #261 – Antivirals for COVID-19
Clinical Question: Do treatments such as remdesivir or other anti-virals change patient outcomes in COVID-19 patients? Bottom Line: To date, published RCTs have not demonstrated benefit of treating COVID-19 patients with remdesivir, lopinavir-ritonavir or oseltamivir. There are signals of potential benefits from one interim analysis of remdesivir and non-statistically different results, but more research is needed. Full publication of studies…Read More
TFP #260 – Are there tools to help assess dyspnea virtually?
Clinical Question: Are there any techniques (like the Roth Score) to augment a typical history when assessing dyspnea/pneumonia over the phone or by video? Bottom Line: Unfortunately, no specific technique, including the Roth Score, is reliable in assuring dyspneic patients are not at risk and safe to stay home. Furthermore, no studies have evaluated dyspnea assessment in…Read More
TFP #259 – Unmasking the evidence around masks for healthcare workers
Clinical Question: Is there a difference between mask types in preventing viral respiratory infections for healthcare workers? Bottom Line: In healthcare workers; Surgical masks and respirators (N95) appear to provide similar protection against viral infections, with N95 masks having slightly lower, but not statistically different, infection rates in the wearer (~1-2%). Cloth masks are less effective than…Read More