New guideline for ED weighs PDE-5 inhibitors, hormones

A new guideline from the American College of Physicians takes no stand one way or the other on the use of hormonal testing or hormone-based treatments for erectile dysfunction (ED). For initial treatment, it says, most affected men should try one of the available phosphodiesterase-5 (PDE-5) inhibitors, based on their own preference, ease of use, cost, and side effects. (Full text is available for free.)

RESULT: Hormonal Testing and Pharmacological Treatment of Erectile Dysfunction
Annals of Internal Medicine | Oct 19, 2009

The journal has also published the systematic review behind the guidelines. It finds no differences in effectiveness or adverse effects among the various PDE-5 inhibitors.

RESULT: Oral Phosphodiesterase-5 Inhibitors and Hormonal Treatments for Erectile Dysfunction: A Systematic Review and Meta-analysis
Annals of Internal Medicine | Oct 19, 2009

Search: erectile dysfunction

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OTHER RECENT SEARCHES ON SEARCHMEDICA

Search: physician leadership

RESULT: How Perceived Physician Leadership Behavior Affects Physician Satisfaction
Mayo Clinic Proceedings | Nov 19, 2008

Physicians’ satisfaction with their physician colleagues in leadership positions is shaped by five key factors, according to this study from the Mayo Clinic. Ironically, the factors that led to the greatest satisfaction were the ones least often displayed.

Search: MRSA infection

RESULT: MRSA infections in patients treated with tumour necrosis factor inhibitors
Annals of the Rheumatic Diseases | Nov 1, 2009

Patients may already be carriers of methicillin-resistant Staphylococcus aureus (MRSA) when they start taking tumor necrosis factor (TNF) inhibitors for arthritis, warn the authors of this 430-patient retrospective study from Maryland. Among the 15 patients in whom MRSA developed, most infections were severe and required hospitalization. Seven of those patients had recurrences of MRSA after TNF inhibitor treatment was restarted.

Search: comparison of ilioinguinal nerve block versus regional nerve block in inguinal hernia

RESULT: A Multi-Site Randomized Controlled Trial Comparing Regional and General Anesthesia for Effects on Neurodevelopmental Outcome and Apnea in Infants
ClinicalTrials.gov | Jun 23, 2009

Children’s Hospital Boston is coordinating a multicenter study to test the neurodevelopmental effects of regional versus general anesthesia on infants undergoing inguinal hernia repair. A major goal of the study is to establish  whether general anesthesia is dangerous for infants, and if so, how.

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SEARCH TIP: The virtue of editing

Whoever typed the search above also tried replacing “comparison” with “benefit” in the search term. Both searches delivered two results describing a trial that was recently suspended because of neurological side effects from ilioinguinal nerve block:

RESULT: Local Anaesthetic Following Hernia Repair
ClinicalTrials.gov | Jan 2, 2009

Following its orders to take the first words in the search term (“comparison of”) most seriously, SearchMedica also finds the dated article below, which praises ilioinguinal nerve block as easier and quicker than spinal anesthesia.

RESULT: Comparison of ilioinguinal-iliohypogastric nerve block versus spinal anesthesia for inguinal herniorrhaphy
Southern Medical Journal (PubMed)| Jan 1, 2006

A better choice would be “ilioinguinal versus regional nerve block inguinal hernia” in which this misleading result (from today’s perspective) does not appear on the first page of results.

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