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Background: Nonopioid Analgesics for Osteoarthritis

Presentation: Analgesics for Osteoarthritis—An Update
Keywords: analgesics | osteoarthritis | background
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Background: Treatment

Presentation: Angiotensin-Converting Enzyme Inhibitors (ACEIs), Angiotensin II Receptor Antagonists (ARBs), or Direct Renin Inhibitors (DRI) for Adults With Hypertension
Keywords: treatment | hypertension | diet | exercise | weight | antihypertensive medication
Managing Rotator Cuff Tears Both nonoperative and operative treatments are used in an attempt to relieve pain and restore shoulder movement and function. Most patients usually first undergo 6 to 12 weeks of nonoperative treatment, which may consist of any combination of pain management (medications and injections), rest from activity, passive and active exercise, and treatments with heat, cold, or ultrasound.
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Managing Rotator Cuff Tears

Presentation: Comparative Effectiveness of Nonoperative and Operative Treatments for Rotator Cuff Tears
Keywords: managing rotator cuff tears | nonoperative | operative | relieve pain | shoulder function | treatment
Early vs. Late Surgical Intervention for Rotator Cuff Tears One randomized controlled trial conducted by Moosmayer et al. compared early surgical repair vs. late surgical repair after failed nonoperative treatment. One hundred and three patients with small or medium-sized full-thickness rotator cuff tears were randomly assigned to nonoperative treatment, which consisted of manual techniques and exercises (n=51) or immediate surgical repair (n=52); 102 patients were followed for a minimum of 12 months. Nine of the patients initially randomized to nonoperative treatment were not satisfied with their degree of improvement after completing 15 treatment sessions, and were offered secondary surgery; these patients constituted the late surgery group. Patients receiving early surgery showed a trend towards superior function when compared with the delayed surgical group on the Constant-Murley Score (improvement of 41.5 points and 33.6 points, respectively); however, the level of significance was not reported and a selection bias may exist due to patients who refused surgery. Overall, evidence is too limited to draw conclusions about the comparative effectiveness of early surgical repair when compared to late surgical repair following nonoperative interventions and the level of evidence was low.
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Early vs. Late Surgical Intervention for Rotator Cuff Tears

Presentation: Comparative Effectiveness of Nonoperative and Operative Treatments for Rotator Cuff Tears
Keywords: operative intervention | return to work | rotator cuff tear | comparative effectiveness
Comparisons Studied for Nonoperative vs. Operative Interventions The operative vs. nonoperative interventions that were studied were as follows: Shock-wave therapy vs. mini-open rotator cuff repair (RCR). Steroid injection, physical therapy, and activity modification vs. open RCR. Physical therapy (manual therapy and strengthening and stability exercises) vs. open or mini-open RCR. Physical therapy, oral medication, and steroid injection vs. open RCR vs. arthroscopic debridement. Steroid injection, stretching, and strengthening vs. open RCR. Two randomized controlled trials and three cohort studies compared nonoperative treatment vs. operative RCR. The nonoperative treatments across the five studies varied in their components. Four studies included either physical therapy (treatment components not specified) or stretching and strengthening exercises, with or without the addition of steroid injections, oral medications, activity modification, or manual therapy. One study examined the use of shock-wave therapy. Nonoperative treatments were compared to either open or mini-open RCR. One study included a third comparison group undergoing arthroscopic debridement.
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Comparisons Studied for Nonoperative vs. Operative Interventions

Presentation: Comparative Effectiveness of Nonoperative and Operative Treatments for Rotator Cuff Tears
Keywords: mini-open repair | nonoperative | open repair | operative | physical therapy | rotator cuff tear | steroid injection | comparative effectiveness
Postoperative Rehabilitation Options for Rotator Cuff Tears The postoperative rehabilitation comparisons studied in the 11 postoperative rehabilitation studies (10 comparative, 1 uncontrolled) are as follows: Physical therapy with or without continuous passive motion Land-based therapy with or without aquatic therapy Inpatient vs. day-patient rehabilitation Home exercise program with or without individualized physical therapy programs Early progressive activation and then resistive exercises vs. early immobilization followed by delayed progressive resistive exercise Standardized vs. nonstandardized physical therapy programs Videotape vs. physical therapy home-exercise instruction
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Postoperative Rehabilitation Options for Rotator Cuff Tears

Presentation: Comparative Effectiveness of Nonoperative and Operative Treatments for Rotator Cuff Tears
Keywords: postoperative rehabilitation | rotator cuff tear | comparative effectiveness
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What to Discuss With Your Patients

Presentation: Comparing Medications for Adults With Type 2 Diabetes
Keywords: patients | shared decisionmaking | goals | adherence | reporting adverse events
On Data Extraction (II). Data extraction involves more than copying words and numbers from the publication to a form. Clinical domain, methodological, and statistical knowledge is needed to ensure the right information is captured. Interpretation of published data is often needed. What is reported is sometimes not what was carried out. Data extraction and evaluation of risk of bias and of applicability typically occur at the same time.
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On Data Extraction (II)

Presentation: Data Extraction
Keywords: data extraction | observational studies | risk of bias | applicability
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Background: Treatment of Obstructive Sleep Apnea (2 of 2)

Presentation: Diagnosis and Treatment of Obstructive Sleep Apnea in Adults
Keywords: surgery | treatment | standards
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Other Outcomes of Interest (1 of 2)

Presentation: Diagnosis and Treatment of Obstructive Sleep Apnea in Adults
Keywords: outcome | strength of evidence | compliance | questionnaire | mandibular advancement device | MAD | continuous positive airway pressure | CPAP | apnea-hypopnea index | AHI | surgery | treatment | oral device
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Other Outcomes of Interest (2 of 2)

Presentation: Diagnosis and Treatment of Obstructive Sleep Apnea in Adults
Keywords: outcome | strength of evidence | compliance | questionnaire | mandibular advancement device | MAD | continuous positive airway pressure | CPAP | apnea-hypopnea index | AHI | surgery | treatment | oral device
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What To Discuss With Your Patients and Their Caregivers

Presentation: Drug Therapy for Rheumatoid Arthritis in Adults
Keywords: rheumatoid arthritis | RA | DMARDs | disease-modifying | antirheumatic | anti-rheumatic | rheumatic | biologic DMARD | withdrawal | adverse events | adverse effects | certolizumab pegol | etanercept | rituximab | anakinra | infliximab
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