Subclinical Atrial Fibrillation and the Risk of Stroke
One quarter of strokes are of unknown cause, and subclinical atrial fibrillation may be a common etiologic factor. Pacemakers can detect subclinical episodes of rapid atrial rate, which correlate with electrocardiographically documented atrial fibrillation. We evaluated whether subclinical episodes of rapid atrial rate detected
by implanted devices were associated with an increased risk of ischemic stroke in patients who did not have other evidence of atrial fibrillation. Subclinical atrial tachyarrhythmias, without clinical atrial fibrillation, occurred frequently in patients with pacemakers and were associated with a significantly increased risk of ischemic stroke or systemic embolism.
N Engl J Med 2012; 366:120-129January 12, 2012
http://www.nejm.org/doi/full/10.1056/NEJMoa1105575

Should patients be entitled to cesarean section on demand?
YES
Canadian Family Physician November 2011 vol. 57 no. 11 1246-1248
http://www.cfp.ca/content/57/11/1246.full

Should patients be entitled to cesarean section on demand?
NO
Canadian Family Physician November 2011 vol. 57 no. 11 1247-1248
http://www.cfp.ca/content/57/11/1247.full

The role of facemasks and hand hygiene in the prevention of
influenza transmission in households: results from a cluster
randomised trial; Berlin, Germany, 2009-2011.
We aimed to investigate efficacy, acceptability, and tolerability of non-pharmaceutical interventions (NPI) in households with influenza index patients. Results suggest that household transmission of influenza can be reduced by the use of NPI, such as facemasks and intensified hand hygiene, when implemented early and used diligently. Concerns about acceptability and tolerability of the interventions should not be a reason against their recommendation.
BMC Infectious Diseases 2012, 12:26 doi:10.1186/1471-2334-12-26
http://www.biomedcentral.com/1471-2334/12/26/abstract

The near disappearance of genital warts in young women
4 years after commencing a national human papillomavirus
(HPV) vaccination programme
Australia provided free quadrivalent human papillomavirus vaccines to 12–18-year-old girls and women aged ≤26 years from mid-2007 until the end of 2009. After this time, only girls aged 12–13 years had access to free vaccines. Methods Before and after the study, of the proportion of new patients attending Melbourne Sexual Health Centre from mid-2004 to mid-2011, diagnosed with genital warts (GW) by risk group. The dramatic decline and near disappearance of GW in women and men under 21 years of age, 4 years after commencing this programme, suggest that the basic reproductive rate has fallen below one.
Sex Transm Infect 2011;87:544-547
http://sti.bmj.com/content/87/7/544.abstract

Low Back Pain and Best Practice Care: A Survey of General Practice Physicians
Acute low back pain (LBP) is primarily managed in general practice. We aimed to describe the usual care provided by general practitioners (GPs) and to compare this with recommendations of best practice in international evidence-based guidelines for the management of acute LBP. The usual care provided by GPs for LBP does not match the care endorsed in international evidence-based guidelines and may not provide the best outcomes for patients. This situation has not improved over time. The unendorsed care may contribute to the high costs of managing LBP, and some aspects of the care provided carry a higher risk of adverse effects.
Arch Intern Med. 2010;170(3):271-277.
http://archinte.ama-assn.org/cgi/content/abstract/170/3/271

To read the abstracts of the titles below go to the archive

1) Anxiety in adolescents: Update on its diagnosis and treatment for primary care providers

2) Use of prescription paracetamol during pregnancy and risk of asthma in children: a population-based Danish cohort study

3) Optimal management of urinary tract infections in older people

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