No studies address whether continued screening for microalbuminuria once a patient is taking an angiotensin-converting enzyme (ACE) inhibitor or angiotensin-2 receptor blocker (ARB) improves outcomes. Indirect evidence and ...

The use of inhaled corticosteroids at conventional doses for asthma and chronic obstructive pulmonary disease (COPD) does not appear to be associated with significant bone loss at 2 to 3 years of follow-up (strength of ...

Low-dose inhaled corticosteroids are the preferred treatment for children with mild persistent asthma because they demonstrate superior reduction in severity and frequency of asthma exacerbations compared with alternatives ...

The use of topical triple-antibiotic ointments significantly decreases infection rates in minor contaminated wounds compared with a petrolatum control. Plain petrolatum ointment is equivalent to triple-antibiotic ointments ...

In African Americans with hypertension, therapy is best initiated with the low-sodium Dietary Approaches to Stop Hypertension (DASH) diet and a thiazide-type diuretic (strength of recommendation [SOR]: A, based on randomized ...

The evaluation and follow-up of an isolated, enlarged cervical lymph node is determined by the presence of inflammation, duration, size, and associated symptoms. For patients with inflammatory symptoms (ie, fever, pain, ...

Use a combination of Wells score and D-dimer test to exclude deep vein thrombosis in low- to intermediate-risk outpatients with suggestive symptoms. Stength of recommendation (SOR) A: B ased on one good meta-analysis.

Kidney stones? It's time to rethink those meds. Despite being recommended for ureteral stone expulsion, tamsulosin or nifedipine are no more effective than placebo. Practice changer: Do not prescribe tamsulosin or nifedipine for stone expulsion...

Increasing the dose of vitamin D3 from the current standard of 400-600 IU per day to 1000 IU per day lowers future risk of cancer in women older than age 55 who do not get adequate vitamin D from sun exposure or diet. ...

Consider adding tiotropium to the medication regimen of patients with moderate to very severe chronic obstructive pulmonary disease (COPD), as a multinational study found it to be more effective than salmeterol in preventing ...

Tell patients with diverticular disease that they can eat nuts, corn, and popcorn without fear. There is no truth to the long-held belief that these foods increase the risk of complications. Strength of recommendatin: B: ...

Recommend high-dose vaginal probiotic capsules to prevent recurrent bacterial vaginosis. Stength of recommendation: B: Based on a single high-quality randomized controlled trial (RCT).

Several treatments produce modest, but statistically significant, clinical increases in sexual desire and function in women. The testosterone transdermal patch improves hypoactive sexual desire disorder (HSDD) in postmenopausal ...

Although inferior vena cava filters (IVCFs) reduced the incidence of PE in a randomized controlled trial (RCT), patients treated with IVCFs and anticoagulation with unfractionated heparin or low-molecular- weight heparin ...

Do not initiate rosiglitazone therapy for patients with diabetes, and consider switching those who are already taking it to pioglitazone. Stength of recommendation: A: Based on a meta-analysis of 56 randomized trials....

Patients with moderate to high cardiac risk (a Revised Cardiac Risk Index [RCRI] score of 2 or higher [Table]) have a reduced risk of in-hospital death following perioperative beta-blocker therapy (strength of recommendation ...

When prescribing combined oral contraceptives, choose one containing levonorgestrel and low-dose estrogen (20 mcg) to minimize the risks of pulmonary embolism, ischemic stroke, and myocardial infarction.

Monitor the growth of exclusively breastfed babies by plotting routine weights and lengths on the World Health Organization (WHO) growth curve (strength of recommendation [SOR]: A, systematic reviews). Reassure parents ...

When you initiate antidepressant therapy for patients who have not been treated for depression previously, select either sertraline or escitalopram. A large meta- analysis found these medications to be superior to other ...

Use an age-adjusted D-dimer cutoff (patient's age in years [multiplied by] 10 mcg/L) for patients over age 50 years when evaluating for venous thromboembolism (VTE); it reduces false positives without substantially increasing ...