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FPIN's Help Desk Answers
Sep 1, 2017 Issue
Predictors of Acute Myocardial Infarction
The most useful element for ruling in acute MI is chest pain with radiation to both arms, followed by radiation to the right arm. The most useful elements for ruling out acute MI are pleuritic chest pain, sharp pain, and pain reproduced by palpation.
Aug 15, 2017 Issue
Health Literacy Tools in the Outpatient Setting
Single-question screening tools regarding the need for help with understanding and completing medical forms and reading materials can be effective for detecting inadequate health literacy in the outpatient setting.
Jul 1, 2017 Issue
Gluten-Free Diet for Irritable Bowel Syndrome
The evidence is conflicting on whether gluten-free diets improve symptoms of IBS. Gluten-free diets may improve symptoms such as abdominal pain, stool consistency, and tiredness, and they can be recommended to patients with IBS.
Jun 1, 2017 Issue
Hormonal Contraceptives in Women Who Are Overweight or Obese
Hormonal contraceptives (oral contraceptive pills, implants, patches, and rings) are highly effective in women of all weights.There is no consistently demonstrated increased risk of pregnancy in overweight women using any specific hormonal method of contraception.
May 1, 2017 Issue
Antibiotic Prophylaxis in Patients with Cirrhosis and Upper Gastrointestinal Bleeding
Antibiotics should be used for prophylaxis in hospitalized patients with cirrhosis and upper gastrointestinal bleeding. Prophylaxis reduces all-cause mortality by 21%, as well as bacterial infections and rebleeding.
Apr 1, 2017 Issue
Alzheimer Disease: Monotherapy vs. Combination Therapy
Combination treatment with memantine and donepezil results in a small improvement in cognitive function that is of uncertain clinical significance in patients with moderate to severe Alzheimer disease, but no improvement in patients with mild to moderate disease.
Mar 1, 2017 Issue
Topical Medications for Seborrheic Dermatitis
Steroids and antifungal agents can be used to effectively treat seborrheic dermatitis. Calcineurin inhibitors are as effective as steroids, but have a higher incidence of short-term adverse effects.
Feb 1, 2017 Issue
Peripheral Vascular Disease: Treatment in Older Adults
PVD can be effectively treated with supervised exercise therapy, cilostazol, lipid-lowering therapy, and antiplatelet therapy. All of these treatments increase pain-free walking distance. Antiplatelet therapy also decreases the need for surgical revascularization. The best treatment is supervised exercise therapy, which increases maximal pain-free walking distance by up to 180 m.
Jan 1, 2017 Issue
Membrane Sweeping to Decrease Rates of Postdate Induction
In uncomplicated pregnancies, membrane sweeping at 38 to 40 weeks' gestation safely decreases the rate of postdate inductions. Membrane sweeping increases the incidence of spontaneous labor, especially in the subsequent seven days, and results in fewer pregnancies extending beyond 41 weeks.
Dec 1, 2016 Issue
Rotator Cuff Disease: Diagnostic Tests
A positive lag sign with external rotation is the best test for full-thickness tears of the infraspinatus and supraspinatus (positive likelihood ratio = 7.2). A positive lag sign with internal rotation is best for assessing full-thickness tears of the subscapularis (positive likelihood ratio = 5.6).