FPIN's Help Desk Answers

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).

Nov 1, 2016 Issue
Topical Antifungals for Treatment of Onychomycosis
Topical antifungal agents are effective in treating onychomycosis, with a number needed to treat (NNT) of 7 to 17.

Oct 1, 2016 Issue
Stretching for Prevention of Exercise-Related Injury
Stretching before exercise does not reduce the risk of injury. However, it may slightly reduce postexercise muscle soreness.

Sep 1, 2016 Issue
Alternatives to Metformin for Patients with PCOS
Compared with placebo, thiazolidinediones (TZDs) decrease systolic blood pressure and fasting blood glucose and insulin levels while improving menstrual irregularities in women with PCOS. Metformin and TZDs have similar effects on pregnancy rates, ovulation, and menstrual frequency, but TZDs can cause weight gain and lower free testosterone and dehydroepiandrosterone (DHEA) levels to a greater degree, whereas metformin reduces body mass index (BMI) and serum triglyceride levels to a greater degree.

Aug 1, 2016 Issue
Exercise to Improve Functioning in Patients with Dementia
Exercise programs lasting at least two months moderately increase the ability of patients with dementia to perform ADLs.

Jun 1, 2016 Issue
Levonorgestrel-Releasing Intrauterine System vs. Oral Progestins for Treatment of Endometrial Hyperplasia
The levonorgestrel-releasing intrauterine system achieves significantly higher resolution rates of endometrial hyperplasia without atypia compared with cyclic oral progestins (68% to 100% vs. 48% to 69%, respectively).

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