Variables that increase the risk of overweight in childhood include formula feeding, high birth weight, high rate of weight gain in the first 4 months of life, low socioeconomic status, and maternal obesity (strength ...

Conservative measures—followed by corticosteroid injection, if necessary—are best. Conservative therapy includes rest, nonsteroidal anti-inflammatory drugs (NSAIDs), and stretching exercises focused on the lower back ...

Physical exam is useful, but imperfect, in ruling out testicular torsion (strength of recommendation [SOR]: C, expert opinion). The cremasteric reflex or a nontender testicle usually excludes testicular torsion, but ...

A high-fiber diet is often prescribed after recovery from acute diverticulitis, based on extrapolation from epidemiologic data showing an association between low-fiber diets and diverticulosis (strength of recommendation ...

Six to 8 weeks after the start of levothyroxine therapy you should reexamine patients and measure their serum thyroid-stimulating hormone (TSH) (strength of recommendation [SOR]: C, common practice and expert opinion). ...

There is no evidence from comparative trials to suggest a single best treatment method for anogenital molluscum contagiosum. Randomized controlled trials suggest self-administered topical imiquimod or podophyllotoxin cream ...

Magnetic resonance angiography (MRA) and computed tomography angiography (CTA) are the most consistently accurate, noninvasive screening methods. MRA is likely the preferred option because of its lack of radiation and ...

Several interventions may reduce the risk of contrast nephropathy for high-risk patients; however, most evidence uses surrogate markers for clinically relevant outcomes. Because dehydration is a risk factor for developing contrast nephropathy...

Jaw claudication, diplopia, or a temporal artery abnormality on physical exam increase the likelihood of temporal arteritis. A finding of thrombocytosis in a patient with suspected temporal arteritis moderately increases ...

Patients can gain more pain relief from spinal cord stimulation (SCS) than from reoperation (strength of recommendation [SOR]: A, 2 randomized controlled trials [RCTs]). SCS can also treat chronic low back pain effectively ...

Beta-blockers without intrinsic sympathomimetic activity, amitriptyline, divalproex sodium/sodium valproate, and topiramate are the most effective drugs for preventing episodic migraine (strength of recommendation: A, ...

No combination of clinical findings can reliably distinguish acute viral rhinosinusitis from acute bacterial rhinosinusitis in primary care. Although unreliable, the best clinical predictor of acute bacterial sinusitis is the combination...

Excision is the most effective treatment for thrombosed external hemorrhoids (strength of recommendation [SOR]: B, retrospective studies). For prolapsed internal hemorrhoids, the best definitive treatment is traditional ...

Most recent randomized controlled clinical trials have not found a benefit in antioxidants (vitamin C, vitamin E, and/or beta-carotene) for preventing cardiovascular disease, including stroke. These recent clinical studies have not confirmed earlier...

This issue of eMedRef provides general background information to clinicians on injuries that may occur during skiing.

Recommendations for measuring serum aminotransferase levels before initiating pharmacologic treatment for hypercholesterolemia, after 12 weeks of therapy, and periodically afterward are based on expert opinion. It is not ...

There is insufficient evidence to recommend for or against an EST for screening asymptomatic individuals of any age. (Grade of Recommendation: C, based on case series.)

Routine amniotomy doesn't significantly reduce the duration of first-stage labor in either primiparous or multiparous women (strength of recommendation [SOR]: A, systematic review of several randomized, controlled trials ...

on consensus guidelines) due to poor diagnostic accuracy. When you suspect GABHS pharyngitis either clinically or epidemio-logically, confirm the diagnosis of pharyngitis by a laboratory test. Patients with a positive throat culture or a rapid antigen detection...

Treating patients with early-stage Alzheimer's disease yields statistically significant, though perhaps not clinically significant, improvement in cognition and global function (strength of recommendation [SOR]: A, consistent evidence from multiple...