Article
Does antepartum perineal massage reduce intrapartum lacerations?
- Author:
- John Dame, MD
- Jon Neher, MD
- Sarah Safranek, MLIS
EVIDENCE-BASED ANSWER: Yes—to a point. Antepartum perineal massage reduces both the incidence of perineal trauma requiring suturing and the...
Article
Is training patients in self-examination an effective way to screen for melanoma?
- Author:
- Margaret Collins, MD
- Gary Kelsberg
- Sarah Safranek, MLIS
EVIDENCE-BASED ANSWER: No, it’s not. No studies demonstrate that training patients to examine their skin decreases mortality from melanoma in the...
Article
Is osteopathic manipulation effective for headaches?
- Author:
- Ashley C. Keays, DO, MPH
- Jon O. Neher, MD
- Sarah Safranek, MLIS
EVIDENCE-BASED ANSWER: It can be. Spinal manipulative therapy (SMT), a component of osteopathy, has been shown to be variably effective for the...
Article
How should you document a patient’s refusal to undergo a necessary intervention?
- Author:
- Christina Tanner
- BCL
- LLB
- MD
- Sarah Safranek, MLIS
EVIDENCE-BASED ANSWER: Your documentation of a patient’s refusal to undergo a test or intervention should include: an assessment of the patient’s...
Article
When are antibiotics indicated for acute COPD exacerbations?
- Author:
- Emily Balser, MD
- Jon O. Neher, MD
- Sarah Safranek, MLIS
EVIDENCE-BASED ANSWER: Antibiotics (including those given orally) reduce mortality and treatment failures for hospitalized patients with acute...
Article
What is the risk of adverse outcomes in a woman who develops mild hypertension from OCs?
- Author:
- Trisha Pollara, MD
- Gary Kelsberg, MD
- Sarah Safranek, MLIS
EVIDENCE-BASED ANSWER: Women who take oral contraceptives (OCs) have an increased risk of developing new hypertension, which returns to baseline...
Article
What is the recommended approach to asymptomatic patients who develop a reactive PPD?
- Author:
- Umang Sharma, MD
- Carl Morris, MD
- Sarah Safranek, MLIS
EVIDENCE-BASED ANSWER: Clinical evaluation and chest x-ray are recommended for asymptomatic patients with a positive purified protein derivative (...
Article
What is the recommended evaluation and treatment for elevated serum prolactin?
- Author:
- Jo Jackson, MD
- Sarah Safranek, MLIS
EVIDENCE-BASED ANSWER: History and physical examination can distinguish among most physiologic, pharmacologic, or pathologic causes of an elevated...
Article
What treatments prevent miscarriage after recurrent pregnancy loss?
- Author:
- Matt Price, MD
- Gary Kelsberg, MD
- Sarah Safranek, MLIS
EVIDENCE-BASED ANSWER: Progesterone produces a small but significant decrease in miscarriage among pregnant women with 3 or more unexplained...
Article
Is therapy based on endoscopy results better than empiric therapy for dyspepsia?
- Author:
- Kevin Rich, MD
- Sarah Safranek, MLIS
EVIDENCE-BASED ANSWER: In the initial management of dyspepsia for patients without “alarm” symptoms (weight loss, recurrent vomiting, dysphagia,...
Article
Does anticoagulation prevent thrombosis for persons with fractures distal to the hip?
- Author:
- Julie Brogren, MD
- Gary Kelsberg, MD
- Sarah Safranek, MLIS
EVIDENCE-BASED ANSWER: Low-molecular-weight heparin (LMWH) prophylaxis significantly reduces the total incidence of deep venous thrombosis (DVT)...
Article
Is sputum evaluation useful for patients with community-acquired pneumonia?
- Author:
- Carl G. Morris, MD
- Sarah Safranek, MLIS
EVIDENCE-BASED ANSWER: No high-quality studies specifically address the utility of sputum Gram stain or culture in the assessment or treatment of...
Article
What is the most effective treatment for ADHD in children?
- Author:
- Lisa A. Johnson, MD
- Sarah Safranek, MLIS
EVIDENCE-BASED ANSWER: Stimulant medication therapy is the most effective treatment for attention deficit/hyperactivity disorder (ADHD) in...
Article
Do antipyretics prolong febrile illness?
- Author:
- Laura Hudgings, MD
- Kelsberg, Gary
- Sarah Safranek, MLIS
EVIDENCE-BASED ANSWER: Antipyretics appear to have minor and variable effects on the course of febrile illness. Aspirin and acetaminophen do not...
Article
Which infants need lumbar puncture for suspected sepsis?
- Author:
- Sarah Wilhelm, MD
- Gary Kelsberg, MD
- Sarah Safranek, MLIS
EVIDENCE-BASED ANSWER: Evidence from prospective and retrospective clinical trials suggests that for infants <2 months old, only those at high...