A Hippocratic Dilemma: Reducing rates of c-sections and prednisolone vs. pentoxifylline for alcoholic hepatitis.

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Amol and Nathan want you to understand the following:

1. A large randomized evaulation of a quality improvement intervention demonstrated a modest but significant reduction in rates of cesarean-section in Quebec.

2. A large double-blind randomized-controlled-trial of over 1100 patients showed that pentoxifylline is not beneficial in the treatment of alcoholic hepatitis and prednisolone may have mild early benefits but does not have long-term benefit.

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The papers

MR Thursz et al. Prednisolone or Pentoxifylline for Alcoholic Hepatitis. N Engl J Med. 2015 Apr 23;372(17):1619-28. (PubMed).

N Chaillet et al. A cluster-randomized trial to reduce cesarean delivery rates in Quebec. N Engl J Med. 2015 Apr 30;372(18):1710-21. (PubMed).

Good Stuff

SG Morgan et al. Estimated cost of universal public coverage of prescription drugs in Canada. CMAJ. 2015 Apr 21;187(7):491-7.

MB Stanbrook. Canada can afford universal pharmacare — no more excuses. CMAJ. 2015 Apr 21; 187(7):495.

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