November

Incorporating high-quality evidence into clinical decision making re­quires systematic searching, appraising, and synthesizing of the literature.

Performing these complex and time-consuming tasks on a regular basis is beyond reasonable expectations for busy physicians, so using existing sources of evidence-based information, particularly systematic reviews, is helpful. 

Confidentially, could you resist looking at your pattern of an­ti­biotic prescribing and comparing it with evidence? Without anyone else knowing? 

If you are a GP in active practice, you will soon receive a sealed, coded envelope containing a confidential portrait (seen by no one) of your prescribing of antibiotics for urinary tract infections (UTI). Its goal is to reverse recent growth in antibi­otic resistance. Yes, we can! Studies have demonstrated the potential for reduced antibiotic resistance following reduced antibiotic prescribing.[1] 

References

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Major joint arthroplasty is undoubtedly one of the surgical success stories of modern times. The number of primary knee arthroplasties performed annually increased exponentially over the last half of the 20th century and increased between 16% and 44% during the first 5 years of the 21st century.[1,2] 

The current long-term success of total hip replacement (THR) surgery has led to the observation by Coventry[1] that “total hip replacement, indeed, might be the orthopaedic operation of the century.” 

The indications for THR have expanded to such an extent that this surgery is no longer performed only in the elderly or in those with de­bilitating hip pain, arthritis, and severe functional restrictions. 

The impact of osteoarthritis on the health care system is significant and continues to grow as our population ages. As there is no cure for degenerative joint disease (DJD), medical interventions have focused on symptom control. 

Unfortunately, none of the nonoperative measures are universally successful and some have significant risks. A minimally invasive day-care procedure that improves patient function and delays more extensive reconstruction is appealing.