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Which patients with metabolic syndrome benefit from metformin?
EVIDENCE-BASED ANSWER: Patients at highest risk for progression to diabetes benefit from metformin.
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Does knuckle popping lead to arthritis?
EVIDENCE-BASED ANSWER: No, habitual knuckle popping, or cracking (over the course of several decades) isn’t associated with clinical or...
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Which SSRIs most effectively treat depression in adolescents?
EVIDENCE-BASED ANSWER: We don’t know which selective serotonin reuptake inhibitors (SSRIs) are the most effective and safe because no studies have...
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Which nonhormonal treatments are effective for hot flashes?
EVIDENCE-BASED ANSWER: Selective serotonin reuptake inhibitors (SSRIs [fluoxetine, sertraline, paroxetine]) and the selective norepinephrine...
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Does caffeine intake during pregnancy affect birth weight?
EVIDENCE-BASED ANSWER: No. Reducing caffeinated coffee consumption by 180 mg of caffeine (the equivalent of 2 cups) per day after 16 weeks’...
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Is lower BP worth it in higher-risk patients with diabetes or coronary disease?
EVIDENCE-BASED ANSWER: There is no simple answer; the risk/benefit picture is complicated. Controlling blood pressure to a target of 130/80 mm Hg...
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Is arthroscopic subacromial decompression effective for shoulder impingement?
EVIDENCE-BASED ANSWER: It’s impossible to say for certain in the absence of randomized controlled trials. However, in patients whose impingement...
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Does high dietary soy intake affect a woman’s risk of primary or recurrent breast cancer?
EVIDENCE-BASED ANSWER: No, it doesn’t affect the risk of primary breast cancer, but it does (favorably) affect the risk of cancer recurrence.
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Does qHPV vaccine prevent anal intraepithelial neoplasia and condylomata in men?
EVIDENCE-BASED ANSWER: Yes. Quadrivalent human papillomavirus (qHPV) vaccine reduces rates of anal intraepithelial neoplasia (AIN) by 50% to 54%,...
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What therapies alleviate symptoms of polycystic ovary syndrome?
EVIDENCE-BASED ANSWER: Treatment of polycystic ovary syndrome (PCOS) in women not actively seeking to become pregnant is symptom-specific....
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Does primary nocturnal enuresis affect childrens’ self-esteem?
EVIDENCE-BASED ANSWER: Yes. Children with primary nocturnal enuresis often, but not always, score about 10% lower on standardized rating scales...
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Is red-yeast rice a safe and effective alternative to statins?
EVIDENCE-BASED ANSWER: Yes, but perhaps not the red-yeast rice extracts available in the United States. In patients with known coronary artery...
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Does any antidepressant besides bupropion help smokers quit?
EVIDENCE-BASED ANSWER: Yes, nortriptyline approximately doubles smoking cessation rates, an effect comparable to bupropion. Adding nortriptyline...
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Do oral contraceptives put women with a family history of breast cancer at increased risk?
EVIDENCE-BASED ANSWER: No. Modern combined oral contraceptive pills (OCPs) don’t increase breast cancer risk in women with a family history (...
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Are topical nitrates safe and effective for upper extremity tendinopathies?
EVIDENCE-BASED ANSWER: Topical nitrates provide short-term relief with some side effects, especially headache. Topical nitroglycerin (NTG) patches...