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Physical Therapy vs Surgery for Meniscal Tears
Arthroscopic partial meniscectomy is among the most frequently performed procedures in orthopedic surgery, but some evidence suggests that physical therapy may have a similar long-term benefit. Van de Graaf and colleagues for the Escape Research Group randomized 321 patients with nonobstructive meniscal tears and found that physical therapy was noninferior to arthroscopic partial meniscectomy for improving patient-reported knee function over 24-month follow-up. In an Editorial, Jazrawi and colleagues suggest that many patients with meniscal tears associated with degenerative osteoarthritis may respond to nonoperative treatment.
Racial Differences in Risk Factors for Hypertension
Understanding racial differences in the prevalence of risk factors for hypertension could guide efforts to reduce disparities in cardiovascular disease. Howard and colleagues followed 6897 black and white adults for a median of 9.4 years and found that Southern diet score, dietary ratio of sodium to potassium, and education level mediated racial differences in the incidence of hypertension.
Outcomes of Treatment for Subclinical Hypothyroidism
It is unclear whether thyroid hormone therapy is beneficial for subclinical hypothyroidism, defined as elevated thyroid-stimulating hormone with normal free thyroxine. In a meta-analysis of 21 trials with 2192 adults who had subclinical hypothyroidism, Feller and colleagues found that the use of thyroid hormone therapy was not associated with improvements in general quality of life or thyroid-related symptoms.
Clinical Review & Education
Treatment of Rheumatoid Arthritis
Control of rheumatoid arthritis can be achieved with disease-modifying antirheumatic drugs, which reduce inflammation, improve physical function, and slow the progression of joint damage. Aletaha and Smolen review the clinical management of patients using a treat-to-target strategy.
Evaluation of an Adrenal Incidentaloma
This JAMA Diagnostic Test Interpretation article by Ospina and colleagues presents a 66-year-old man with an adrenal mass discovered during radiological evaluation for a reason other than suspected adrenal disease. Laboratory results indicated possible autonomous production of cortisol. What would you do next?
Ciprofloxacin Otic Suspension for Acute Otitis Externa
Topical antibiotic therapy is the treatment of choice for acute otitis externa, but a typical course of treatment is 7 to 10 days. This Medical Letter on Drugs and Therapeutics discusses the efficacy and safety of a single dose of ciprofloxacin for acute otitis externa caused by Pseudomonas aeruginosa or Staphylococcus aureus.
Highlights. JAMA. 2018;320(13):1297–1299. doi:10.1001/jama.2017.12570
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