Emergency medicine literature of note musings on publications and studies relevant to em. viagra time span Saturday, may 5, 2012 rational clinical examination: gi bleeding this series of articles, "the rational clinical examination" in jama is by far one of my favorite approaches to medicine. can take 40 mg viagra  they ask simple clinical questions, and they do literature searches to find evidence to apply.  additionally, the form in which they distill the evidence tends to be likelihood ratios - a far more useful statistical construct in estimating how a particular finding contributes to ruling-in or ruling-out disease. This most recent literature review covers gastrointestinal bleeding - and it covers a few worthwhile points. viagra 50 y 100  most encouragingly, the authors are exceedingly skeptical about the utility of ng tube placement - reasonable positive lr for ugib, but, as the authors note, a suspected source is usually well-established prior to ng tube placement.  additionally, they note that the ng lavage does not tend to influence final patient-oriented outcomes - and lean towards not recommending its use.  secondly, they also cover the blatchford and rockall scores, which are decision instruments that might have value in helping triage patients for outpatient management. viagra use alcohol "does this patient have a severe upper gastrointestinal bleed? cheap viagra " www. generic viagra 25mg Ncbi. Nlm. viagra time span Nih. viagra online Gov/pubmed/22416103 posted by radecki at 6:00 am email this blogthis! viagra canada online Share to twitter share to facebook labels: clinical decision rules, gastroenterology 3 comments: scott may 14, 2012 12:58 am can you explain, in laymans terms, what a positive lr and a negative lr effectively mean? Reply delete radecki may 14, 2012 10:34 am the brilliant stephen mcgee can do more for you than i can: but, in short, a positive lr of 5. 0 makes a diagnosis approximately 30% more likely, and a negative lr of 0. 2 makes a diagnosis approximately 30% less likely. viagra time span Table 1 of dr. Mcgee's article expands these estimates for other values of positive and negative lr. Reply delete javier benã­tez july 28, 2012 5:55 am thanks for providing such a great article. buy viagra canada "the rational clinical examination" is also one of my favorites. Likelihood ratios should definitely be used more often in clinical practice, they're helpful from different points of view: increase patient's safety, save money, and sharpens your clinical gestalt. lowest price for generic viagra Javier reply delete add comment load more... Newer post older post home subscribe to: post comments (atom) twitter follow @emlitofnote subscribe to posts atom posts comments atom comments follow by email facebook about the blog as. buy viagra cheap ping