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How Long Should Antibiotic Therapy Be Continued for an Uncomplicated, Symptomatic Lower UTI in an Elderly Woman?
Title
How Long Should Antibiotic Therapy Be Continued for an Uncomplicated, Symptomatic Lower UTI in an Elderly Woman?.
Creator
Radkay, Lisa, Rodríguez, Jose
Abstract/Description
Elderly women with symptomatic lower urinary tract infections (UTIs) should be treated for 3 to 6 days with oral antibiotics. This duration provides better short-term outcomes than 1-day therapy and has long-term outcomes equivalent to 7- to 14-day therapy. (SOR B, based on a systematic review of heterogeneous RCTs.)
Date Issued
2010
Identifier
FSU_migr_fmr-0028
Format
Citation
How Are Thyroid Function Tests Altered by Thyroid Replacement Medications?
Title
How Are Thyroid Function Tests Altered by Thyroid Replacement Medications?.
Creator
Shah, Shawn, Rodríguez, Jose
Abstract/Description
Small changes in the dosing of levothyroxine (±25 mcg) are associated with large changes in serum thyroid-stimulating hormone (TSH) and free thyroxine (FT4) concentrations, but not with measurable changes in hypothyroid symptoms, well-being, or quality of life. (SOR: B, based on a single RCT.) Taking levothyroxine while fasting is associated with a higher serum FT4 and lower serum TSH compared with administration after a meal, but these differences are small. (SOR: C, based on a single RCT...
Show moreSmall changes in the dosing of levothyroxine (±25 mcg) are associated with large changes in serum thyroid-stimulating hormone (TSH) and free thyroxine (FT4) concentrations, but not with measurable changes in hypothyroid symptoms, well-being, or quality of life. (SOR: B, based on a single RCT.) Taking levothyroxine while fasting is associated with a higher serum FT4 and lower serum TSH compared with administration after a meal, but these differences are small. (SOR: C, based on a single RCT using disease-oriented outcomes.)
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Date Issued
2010
Identifier
FSU_migr_fmr-0032
Format
Citation
Interventions for Heart Failure
Title
Interventions for Heart Failure.
Creator
Glickman, Michael, Rodríguez, Jose
Abstract/Description
The following interventions improve important outcomes in patients with systolic heart failure (all SORs: A, based on meta-analyses): • Angiotensin converting enzyme (ACE) inhibitors reduce mortality, repeat myocardial infarction (MI), and hospitalization rates • Beta-blockers and aldosterone blockers reduce mortality and hospitalization rates • Diuretics reduce mortality and hospitalization rates and improve exercise capacity • Digitalis treatment decreases hospitalization rates and clinical...
Show moreThe following interventions improve important outcomes in patients with systolic heart failure (all SORs: A, based on meta-analyses): • Angiotensin converting enzyme (ACE) inhibitors reduce mortality, repeat myocardial infarction (MI), and hospitalization rates • Beta-blockers and aldosterone blockers reduce mortality and hospitalization rates • Diuretics reduce mortality and hospitalization rates and improve exercise capacity • Digitalis treatment decreases hospitalization rates and clinical deterioration • Aerobic exercise rehabilitation of at least 6 months in duration decreases hospitalization rates and improves quality of life. The following intervention improves important outcomes in African American patients with systolic heart failure (SOR: B, based on a single RCT): • Isosorbide dinitrate and hydralazine combination therapy reduces mortality and hospitalization rates and improves quality of life.
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Date Issued
2011
Identifier
FSU_migr_fmr-0034
Format
Citation
How Safe and Effective is Pramlintide in Improving Long-Term Glycemic Control and Weight Loss in Patients with Type 2 Diabetes Mellitus Receiving Insulin?
Title
How Safe and Effective is Pramlintide in Improving Long-Term Glycemic Control and Weight Loss in Patients with Type 2 Diabetes Mellitus Receiving Insulin?.
Creator
Iyengar, Sanjana, Love, Kaitlin, Bauerband, Brian, Rodríguez, Jose
Date Issued
2013
Identifier
FSU_migr_fmr-0052
Format
Citation
Is Laparoscopic or Open Surgery Better to Prevent Recurrence of an Inguinal Hernia in an Adult Man?
Title
Is Laparoscopic or Open Surgery Better to Prevent Recurrence of an Inguinal Hernia in an Adult Man?: Update.
Creator
Bada, Alvaro, Rodríguez, Jose
Abstract/Description
The risk of recurrence of inguinal hernia is reduced by the use of synthetic mesh, but does not depend on the specific surgical procedure. Compared with the open approach, laparoscopy requires a longer operation (15 minutes longer on average), but decreases recovery time and reduces persistent pain and numbness. (SOR A, based on a systematic review.) Recurrence rates with laparoscopic inguinal hernia repair are highly operator dependent. (SOR A, based on 2 large randomized controlled trials ...
Show moreThe risk of recurrence of inguinal hernia is reduced by the use of synthetic mesh, but does not depend on the specific surgical procedure. Compared with the open approach, laparoscopy requires a longer operation (15 minutes longer on average), but decreases recovery time and reduces persistent pain and numbness. (SOR A, based on a systematic review.) Recurrence rates with laparoscopic inguinal hernia repair are highly operator dependent. (SOR A, based on 2 large randomized controlled trials [RCTs].)
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Date Issued
2009
Identifier
FSU_migr_fmr-0012
Format
Citation
Is Uterine Artery Embolization (UAE) Safe and Effective for Treatment of Uterine Fibroids?
Title
Is Uterine Artery Embolization (UAE) Safe and Effective for Treatment of Uterine Fibroids?.
Creator
Davis, Laura, Provost, Bridgette, Rodríguez, Jose
Abstract/Description
Compared with hysterectomy or myomectomy, UAE for treating fibroids results in similar patient satisfaction. UAE is associated with fewer blood transfusions, shorter hospital stays, and quicker resumption of normal activities than surgical treatment. However, patients undergoing UAE are more likely to require further intervention at 2 and 5 years and are more likely to have minor complications than patients treated surgically (SOR: A, systematic review of RCTs).
Date Issued
2012
Identifier
FSU_migr_fmr-0044
Format
Citation
Is Calcitonin Useful for Reducing the Pain of Acute Osteoporotic Fractures?
Title
Is Calcitonin Useful for Reducing the Pain of Acute Osteoporotic Fractures?.
Creator
Parker, Alex, Soberon, Angelica, Rodríguez, Jose
Abstract/Description
Calcitonin has been shown to improve acute pain at rest in patients with osteoporotic vertebral fractures, when compared with placebo, and reduce the use of other analgesic medications (SOR A, based on a meta-analysis of randomized controlled trials [RCTs]). However, calcitonin is not superior to placebo in patients with hip fracture who have undergone surgical repair. (SOR B, based on an RCT.)
Date Issued
2009
Identifier
FSU_migr_fmr-0017
Format
Citation
Are Group Visits Effective for the Treatment of Obesity?
Title
Are Group Visits Effective for the Treatment of Obesity?.
Creator
Hofmann, Mikel, Rodríguez, Jose, Shearer, Barbara
Abstract/Description
Weight loss therapy consisting of 20 to 30 lifestyle-modification group visits is associated with modest (4–8 kg) weight loss. (SOR A, based on homogeneous randomized controlled trials [RCTs].) For patients who participate in group visits, use of sibutramine (15 mg p.o. daily) and compliance with food journaling are both associated with greater weight loss. (SOR B, based on an RCT and an outcomes study.)
Date Issued
2010
Identifier
FSU_migr_fmr-0021
Format
Citation
What is the Best Treatment for an Adult with an Umbilical Hernia?
Title
What is the Best Treatment for an Adult with an Umbilical Hernia?.
Creator
Castro, Robert, Rodríguez, Jose
Abstract/Description
The laparoscopic onlay patch repair is associated with less recurrence, shorter hospital stay, lower wound morbidity, and lower postoperative pain when compared with open suture repair. (SOR B, based on a single cohort study.) Open surgical mesh repair of umbilical hernia is associated with less recurrence than open suture repair, but there is controversy surrounding the infection rates associated with this repair. (SOR B, based on heterogeneous cohort studies.)
Date Issued
2009
Identifier
FSU_migr_fmr-0016
Format
Citation
What is the Best Treatment for Patients of All Ages with Community-Acquired Pneumonia?
Title
What is the Best Treatment for Patients of All Ages with Community-Acquired Pneumonia?.
Creator
Smith, Joshua, Rodríguez, Jose
Abstract/Description
Recommended first-line antibiotic therapy for community-acquired (CA) pneumonia is 5 days of a macrolide in adults and 3 to 5 days of amoxicillin in children. (SOR: C, based on consensus guidelines.) In otherwise healthy adults, there is no clear difference in clinical success rates among beta-lactams, fluoroquinolones, macrolides, and cephalosporins.
Date Issued
2012
Identifier
FSU_migr_fmr-0033
Format
Citation
What is the Best Nonpharmacologic Therapy for Phantom Limb Pain?
Title
What is the Best Nonpharmacologic Therapy for Phantom Limb Pain?.
Creator
Miller, Michelle, Rodríguez, Jose
Abstract/Description
Nonpharmacologic therapies for phantom limb pain (PLP) that have demonstrated some success include motor imagery therapy (SOR C, extrapolated from a randomized controlled trial [RCT] that enrolled a heterogeneous patient sample); Farabloc® (SOR C, based on a single low-quality RCT); and eye movement desensitization and reprocessing (EMDR) in patients who also have depression and posttraumatic stress disorder (SOR C, based on a case series). Evidence is insufficient to support or refute the...
Show moreNonpharmacologic therapies for phantom limb pain (PLP) that have demonstrated some success include motor imagery therapy (SOR C, extrapolated from a randomized controlled trial [RCT] that enrolled a heterogeneous patient sample); Farabloc® (SOR C, based on a single low-quality RCT); and eye movement desensitization and reprocessing (EMDR) in patients who also have depression and posttraumatic stress disorder (SOR C, based on a case series). Evidence is insufficient to support or refute the use of transcutaneous electrical nerve stimulation (TENS), desensitization, scar mobilization, relaxation, or biofeedback.
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Date Issued
2010
Identifier
FSU_migr_fmr-0020
Format
Citation
What is the Best Treatment for Postinfluenza Pneumonia?
Title
What is the Best Treatment for Postinfluenza Pneumonia?.
Creator
Smith, Joshua, Rodríguez, Jose
Abstract/Description
Cefotaxime, ceftriaxone, and respiratory fluoroquinolones are recommended for influenza-associated pneumonia. Oseltamivir and zanamivir can be used to reduce viral shedding in hospitalized patients with influenza, with or without pneumonia. (SOR C, based on consensus guidelines.) Early treatment of the influenza infection with oseltamivir or inhaled zanamivir is recommended for prevention of postinfluenza pneumonia. (SOR A, based on a meta-analysis.)
Date Issued
2010
Identifier
FSU_migr_fmr-0027
Format
Citation
What is the Best Treatment for Symptomatic PVD in the Elderly?
Title
What is the Best Treatment for Symptomatic PVD in the Elderly?.
Creator
LeFranc, Noemi, Rodríguez, Jose
Abstract/Description
In patients with peripheral vascular disease (PVD), a structured exercise program improves walking distances and is relatively low risk and low cost. Lipid-lowering therapy reduces the risk of cardiovascular events and also increases walking distances. Cilostazol and naftidrofuryl improve walking distance, but add an additional expense. Angioplasty appears to improve walking distance better than exercise at 6 months, but not at 2 or 6 years. (SOR A, based on a systematic reviews.)
Date Issued
2010
Identifier
FSU_migr_fmr-0026
Format
Citation
What is the Best Prophylaxis for Menstrual Migraine?
Title
What is the Best Prophylaxis for Menstrual Migraine?.
Creator
Barrie, Jamie, Rodríguez, Jose
Abstract/Description
Oral naratriptan results in slightly fewer headache days than placebo in patients with menstrual migraines. (SOR A, based on consistent randomized controlled trials [RCTs].) Naproxen and magnesium therapy are also more effective than placebo. (SOR B, based on single small RCTs.) Frovatriptan may reduce the severity of pain better than transdermal estrogens and naproxen (SOR C, based on a single open-label comparison study), but has not been studied in comparison with a placebo.
Date Issued
2008
Identifier
FSU_migr_fmr-0008
Format
Citation
What is the Best Treatment for Exercise-Induced Asthma?
Title
What is the Best Treatment for Exercise-Induced Asthma?.
Creator
Rodríguez, Jose, Gonzalez, David
Abstract/Description
Patients using the leukotriene inhibitor montelukast require less frequent use of rescue medication than patients using the long-acting beta-agonist salmeterol. (SOR B, based on a single randomized controlled trial [RCT]). No studies have compared short-acting beta-agonists with either leukotriene inhibitors or long-acting beta-agonists.
Date Issued
2008
Identifier
FSU_migr_fmr-0004
Format
Citation
What is the Best Treatment for Graves' Disease in Women Trying to Become Pregnant?
Title
What is the Best Treatment for Graves' Disease in Women Trying to Become Pregnant?.
Creator
Pearcy, Amanda, Rodríguez, Jose
Abstract/Description
It is recommended that pregnant women with Graves' disease and thyroid-stimulating hormone (TSH) antibodies be treated with an antithyroid drug, whereas those without TSH antibodies should simply be observed. Radioiodine treatment with iodine-131 (I-131) is contraindicated when a woman is attempting pregnancy and during pregnancy. Propylthiouracil (PTU) is the first-line drug therapy during the first trimester. (SOR B, from an evidence-based guideline.)
Date Issued
2010
Identifier
FSU_migr_fmr-0025
Format
Citation
What Are the Best Nonpharmacologic Treatments for Urinary Incontinence in Women?
Title
What Are the Best Nonpharmacologic Treatments for Urinary Incontinence in Women?.
Creator
Rojas, Christine, Rodríguez, Jose
Abstract/Description
Pelvic floor muscle training (PFMT) is superior to no treatment or inactive controls, and is effective in nonpregnant, pregnant, and postpartum women. (SOR A, based on meta-analyses.) The clinical value of habit retraining, timed voiding, or mechanical devices for treatment of urinary incontinence is unknown.
Date Issued
2009
Identifier
FSU_migr_fmr-0013
Format
Citation
What Are the Risks of Oral Contraceptives in Patients with Cardiovascular Disease Risk Factors?
Title
What Are the Risks of Oral Contraceptives in Patients with Cardiovascular Disease Risk Factors?.
Creator
Love, Kaitlin, Miller, Michelle, Pemberton, Kenisha, Rodríguez, Jose
Abstract/Description
Women who smoke, have hypertension, hyperlipidemia, or factor V Leiden deficiency and take oral contraception (OC) are at increased risk of myocardial infarction (MI). Third-generation OCs and low-dose OCs are not associated with increased MI risk in women with or without other cardiovascular (CV) risk factors (SOR B, systematic review of cohort studies). OCs are contraindicated in women with preexisting congestive heart failure or CV disease, but may be used in otherwise healthy women with...
Show moreWomen who smoke, have hypertension, hyperlipidemia, or factor V Leiden deficiency and take oral contraception (OC) are at increased risk of myocardial infarction (MI). Third-generation OCs and low-dose OCs are not associated with increased MI risk in women with or without other cardiovascular (CV) risk factors (SOR B, systematic review of cohort studies). OCs are contraindicated in women with preexisting congestive heart failure or CV disease, but may be used in otherwise healthy women with diabetes, hypertension, or hyperlipidemia (SOR C, evidence-based guidelines derived from consensus and expert opinion).
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Date Issued
2013
Identifier
FSU_migr_fmr-0047
Format
Citation
What Are the Causes of Systolic Murmurs in Young Children?
Title
What Are the Causes of Systolic Murmurs in Young Children?.
Creator
Goodwin, Meredith, Dexter, Nadine, Rodríguez, Jose
Abstract/Description
Innocent or functional murmurs are the most common, present at some point in 50% to 90% of children, typically between 2 and 7 years of age. (SOR B, based on a cohort study.) Systolic murmurs due to systemic diseases or infections are the next most common, with anemia being the most frequent cause. (SOR C, based on a narrative review.) Congenital heart disease is the least common cause of a systolic murmur, occurring in less than 1% of the general population. (SOR B, based on a systematic...
Show moreInnocent or functional murmurs are the most common, present at some point in 50% to 90% of children, typically between 2 and 7 years of age. (SOR B, based on a cohort study.) Systolic murmurs due to systemic diseases or infections are the next most common, with anemia being the most frequent cause. (SOR C, based on a narrative review.) Congenital heart disease is the least common cause of a systolic murmur, occurring in less than 1% of the general population. (SOR B, based on a systematic review of cohort studies.)
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Date Issued
2010
Identifier
FSU_migr_fmr-0019
Format
Citation
What Common Food Additives Can Cause Acute, Nonallergic Symptoms?
Title
What Common Food Additives Can Cause Acute, Nonallergic Symptoms?.
Creator
Rodríguez, Jose, Campbell, Sara Chelland, Gallard, Javier
Abstract/Description
Aspartame may be associated with headaches in susceptible individuals (SOR B, based on a small crossover study.) Monosodium glutamate (MSG) is associated with a range of constitutional symptoms; however, with blinding, responses to MSG are rarely consistent. (SOR B, based on a randomized controlled trial [RCT].)
Date Issued
2010
Identifier
FSU_migr_fmr-0022
Format
Citation
What Are Effective Treatments for Painful Varicose Veins?
Title
What Are Effective Treatments for Painful Varicose Veins?.
Creator
Gonzalez, David, Rodríguez, Jose
Abstract/Description
Several ablative therapies are effective. However, endovenous laser ablation (EVLA) has a higher 5-year success rate than surgical stripping, ultrasound-guided foam sclerotherapy (UGFS), and radiofre-quency ablation (RFA). EVLA is also associated with less postoperative pain, and results a faster improvement in health-related quality of life when compared with surgery. (SOR A, based on a meta-analysis.) Compression stockings are not as effective as ablative therapy. (SOR A, based on a meta...
Show moreSeveral ablative therapies are effective. However, endovenous laser ablation (EVLA) has a higher 5-year success rate than surgical stripping, ultrasound-guided foam sclerotherapy (UGFS), and radiofre-quency ablation (RFA). EVLA is also associated with less postoperative pain, and results a faster improvement in health-related quality of life when compared with surgery. (SOR A, based on a meta-analysis.) Compression stockings are not as effective as ablative therapy. (SOR A, based on a meta-analysis.)
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Date Issued
2010
Identifier
FSU_migr_fmr-0029
Format
Citation
What Can Be Done to Slow Progression of Dementia in the Elderly?
Title
What Can Be Done to Slow Progression of Dementia in the Elderly?.
Creator
Parker, Alex, Rodríguez, Jose
Abstract/Description
Cholinesterase inhibitors alone or in combination with memantine delay the rate of nursing home admissions among elderly patients with Alzheimer's disease (AD), but have no statistical influence on mortality. (SOR B, based on an observational study.) Cholinesterase inhibitors are associated with small improvements in cognition and function in patients with AD when compared with placebo (SOR A, based on a meta-analysis.) The total societal medical cost of donepezil therapy is comparable to the...
Show moreCholinesterase inhibitors alone or in combination with memantine delay the rate of nursing home admissions among elderly patients with Alzheimer's disease (AD), but have no statistical influence on mortality. (SOR B, based on an observational study.) Cholinesterase inhibitors are associated with small improvements in cognition and function in patients with AD when compared with placebo (SOR A, based on a meta-analysis.) The total societal medical cost of donepezil therapy is comparable to the cost of placebo. (SOR B, based on 1 randomized controlled trial [RCT].)
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Date Issued
2009
Identifier
FSU_migr_fmr-0015
Format
Citation
What Are the Best Treatments for Reducing Pain Due to Compression Fractures?
Title
What Are the Best Treatments for Reducing Pain Due to Compression Fractures?.
Creator
Bada, Alvaro, Rodríguez, Jose
Abstract/Description
The answer remains unclear. Nasal salmon calcitonin is effective for analgesia of vertebral compression fractures (SOR A, based on a systematic review of randomized controlled trials [RCTs]). Although percutaneous vertebroplasty is slightly more effective than balloon kyphoplasty for reducing pain, it also has a higher refracture rate (SOR A, based on a meta-analysis). Isometric back-extensor muscle strengthening and proprioceptive postural retraining is more effective for prolonging time...
Show moreThe answer remains unclear. Nasal salmon calcitonin is effective for analgesia of vertebral compression fractures (SOR A, based on a systematic review of randomized controlled trials [RCTs]). Although percutaneous vertebroplasty is slightly more effective than balloon kyphoplasty for reducing pain, it also has a higher refracture rate (SOR A, based on a meta-analysis). Isometric back-extensor muscle strengthening and proprioceptive postural retraining is more effective for prolonging time between refractures if there has not been a vertebroplasty (SOR B, based on a case series).
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Date Issued
2009
Identifier
FSU_migr_fmr-0009
Format
Citation
What Are the Most Effective Methods for Managing General Psychosocial Stress?
Title
What Are the Most Effective Methods for Managing General Psychosocial Stress?.
Creator
Rodby, Katherine, Rodríguez, Jose
Abstract/Description
Mindfulness-based stress reduction (MBSR), cognitive-behavioral stress reduction (CBSR), and somatic relaxation are all effective therapies for psychosocial stress. Exercise also reduces stress and improves mental health (SOR B, based on small randomized controlled trials [RCTs]). Anxiolytic agents and antidepressants may be used in refractory cases. (SOR C, expert opinion.)
Date Issued
2009
Identifier
FSU_migr_fmr-0011
Format
Citation
Should Coenzyme Q10 Be Used to Lower Blood Pressure in Asymptomatic Patients?
Title
Should Coenzyme Q10 Be Used to Lower Blood Pressure in Asymptomatic Patients?.
Creator
Barker, Daniella, Rodríguez, Jose
Abstract/Description
Coenzyme Q10 (CoQ10) may lower systolic and diastolic blood pressures in patients with primary hypertension, but is not recommended as an antihypertensive treatment (SOR: C, systematic review of low-quality RCTs using disease-oriented outcomes).
Date Issued
2013
Identifier
FSU_migr_fmr-0046
Format
Citation
What is the Best Treatment for an Adult Whose Asthma Exacerbation Has Not Completely Responded to 5 Days of Oral Corticosteroids?
Title
What is the Best Treatment for an Adult Whose Asthma Exacerbation Has Not Completely Responded to 5 Days of Oral Corticosteroids?.
Creator
Hofmann, Mikel, Rodríguez, Jose, Klatt, Carolyn
Abstract/Description
Current guidelines recommend that patients with acute asthma exacerbations be treated with systemic corticosteroids for 5 to 10 days, so continued steroid therapy is an option. However, limited evidence suggests that a 2-week course of oral steroids may be no more effective than a 1-week course (SOR C, based on a single small randomized controlled trial with a trend favoring prolonged therapy).
Date Issued
2008
Identifier
FSU_migr_fmr-0007
Format
Citation
What is the Role of Carbohydrate-Restricted Diets for Patients with Obesity-Related Diseases (Hyperlipidemia, Diabetes, Hypertension, etc)?
Title
What is the Role of Carbohydrate-Restricted Diets for Patients with Obesity-Related Diseases (Hyperlipidemia, Diabetes, Hypertension, etc)?.
Creator
Nagy, Suzanne, Soberon, Angelica, Rodríguez, Jose
Abstract/Description
Compared with low-fat diets, carbohydrate-restricted diets (eg, Atkins) produce more weight loss in the short term (at 6 months but not at 1 year) and produce a greater reduction in glycosylated hemoglobin (HbA1C). (SOR A, based on a meta-analysis.) However, no studies have been published with more than 1 year duration or have focused on patient-oriented outcomes. The American Diabetes Association now recommends either low-carbohydrate or low-fat calorie-restricted diets for weight loss over...
Show moreCompared with low-fat diets, carbohydrate-restricted diets (eg, Atkins) produce more weight loss in the short term (at 6 months but not at 1 year) and produce a greater reduction in glycosylated hemoglobin (HbA1C). (SOR A, based on a meta-analysis.) However, no studies have been published with more than 1 year duration or have focused on patient-oriented outcomes. The American Diabetes Association now recommends either low-carbohydrate or low-fat calorie-restricted diets for weight loss over the short term. (SOR C, based on expert opinion.)
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Date Issued
2008
Identifier
FSU_migr_fmr-0006
Format
Citation
When is Heparin Indicated for the Management of Acute Stroke?
Title
When is Heparin Indicated for the Management of Acute Stroke?.
Creator
Murphy, Shelley, Rodríguez, Jose
Abstract/Description
Heparin does not appear to improve overall outcomes when used for ischemic stroke or within the first 2 weeks of a cardioembolic stroke. (SOR B, extrapolated from meta-analyses of multiple heparinoids.)
Date Issued
2009
Identifier
FSU_migr_fmr-0018
Format
Citation
Which is the Best Surgical Incision/Technique for Cesarean Section?
Title
Which is the Best Surgical Incision/Technique for Cesarean Section?.
Creator
LeFranc, Noemi, Rodríguez, Jose
Abstract/Description
The Joel-Cohen skin incision is associated with less fever, pain, analgesic use, and blood loss, as well as shorter surgeries and hospital stays when compared with the Pfannenstiel skin incision (SOR: A, based on a systematic review). For uterine incision, the answer is no clear, but blunt dissection is associated with less blood loss when compared with sharp dissection (SOR: A, based on a systematic review and subsequent RCT). Cephalad-caudad blunt dissection appears safer than transverse...
Show moreThe Joel-Cohen skin incision is associated with less fever, pain, analgesic use, and blood loss, as well as shorter surgeries and hospital stays when compared with the Pfannenstiel skin incision (SOR: A, based on a systematic review). For uterine incision, the answer is no clear, but blunt dissection is associated with less blood loss when compared with sharp dissection (SOR: A, based on a systematic review and subsequent RCT). Cephalad-caudad blunt dissection appears safer than transverse blunt dissection (SOR: B, based on 1 RCT).
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Date Issued
2010
Identifier
FSU_migr_fmr-0030
Format
Citation
What is the Most Effective Treatment for Bell's Palsy Among Patients with Diabetes?
Title
What is the Most Effective Treatment for Bell's Palsy Among Patients with Diabetes?.
Creator
Gonzalez, David, Rodríguez, Jose, Talbot, Richard
Abstract/Description
Patients with Bell's palsy have higher cure rates when treated with oral prednisolone within 72 hours of onset (SOR B, based on a single randomized controlled trial), but it is unclear what effect this therapy would have on patients with diabetes. Intravenous lipo-prostaglandin E1 (lipo-PGE1) may be an alternative to steroid therapy for Bell's palsy that does not effect blood glucose levels. (SOR C, based on a single small cohort study.)
Date Issued
2010
Identifier
FSU_migr_fmr-0024
Format
Citation
What Methods Are Effective for Reducing the Incidence of Dental Caries?
Title
What Methods Are Effective for Reducing the Incidence of Dental Caries?.
Creator
Gaar, Micah, Rodríguez, Jose, Alexiev, Elena
Abstract/Description
Fluoride mouth rinses and fluoride toothpastes used regularly at home reduce the incidence of dental caries about 25%. (SOR A, based on systematic reviews of RCTs.) Professionally applied fluoride varnishes reduce carries by about 50%. (SOR A, based on systematic reviews of RCTs.) Pit and fissure sealants provide additional protection beyond fluoride varnishes. (SOR B, based on a meta-analysis with a small number of patients.)
Date Issued
2010
Identifier
FSU_migr_fmr-0023
Format
Citation
What Question Set is Most Effective to Screen Chronic Pain Patients for Potential Opioid Abuse?
Title
What Question Set is Most Effective to Screen Chronic Pain Patients for Potential Opioid Abuse?.
Creator
Rodríguez, Jose, Gonzalez, David
Abstract/Description
The Screener and Opioid Assessment Measure for Patients with Chronic Pain (SOAAP) and the Opioid Risk Tool (ORT) are both validated tools that screen for future problems with prescription opioids. The ORT has been more rigorously studied and is able to identify low-, moderate-, and high-risk populations. (SOR B, based on a single validating cohort study.)
Date Issued
2008
Identifier
FSU_migr_fmr-0005
Format
Citation
What Health Education Interventions Reduce the Progression of Prediabetes to Overt Diabetes in High-Risk Groups?
Title
What Health Education Interventions Reduce the Progression of Prediabetes to Overt Diabetes in High-Risk Groups?.
Creator
Fabrizi, Meghan, Rodríguez, Jose
Date Issued
2013
Identifier
FSU_migr_fmr-0053
Format
Citation
What Therapies Are Effective for Relief of Chronic Vertigo Symptoms?
Title
What Therapies Are Effective for Relief of Chronic Vertigo Symptoms?.
Creator
Crawford, Veronita, Rodríguez, Jose
Abstract/Description
For unilateral peripheral vestibular dysfunction, vestibular rehabilitation (VR) improves subjective dizziness. In benign paroxysmal positional vertigo (BPPV), canalith repositioning maneuvers are associated with excellent short-term relief. (SOR A, based on a systematic review.) In patients with Ménière's disease, instruction in VR and symptom control are equally effective; the Meniett device can produce symptom relief in refractory cases. (SOR B, based on randomized controlled trials [RCTs]...
Show moreFor unilateral peripheral vestibular dysfunction, vestibular rehabilitation (VR) improves subjective dizziness. In benign paroxysmal positional vertigo (BPPV), canalith repositioning maneuvers are associated with excellent short-term relief. (SOR A, based on a systematic review.) In patients with Ménière's disease, instruction in VR and symptom control are equally effective; the Meniett device can produce symptom relief in refractory cases. (SOR B, based on randomized controlled trials [RCTs].) Antihistamines, anticholinergics, benzodiazepines, diuretics, calcium channel blockers, and topiramate may also help relieve symptoms. (SOR C, based on expert opinion.)
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Date Issued
2009
Identifier
FSU_migr_fmr-0010
Format
Citation
What Treatments Are Effective for Nickel Allergy?
Title
What Treatments Are Effective for Nickel Allergy?.
Creator
Lesnick, Joseph, Rodríguez, Jose
Abstract/Description
Preventing further exposure is clearly important. Postexposure, topical tacrolimus and topical steroids improve symptoms of nickel allergy better than placebo (SOR: B, 2 small RCTs).
Date Issued
2013
Identifier
FSU_migr_fmr-0045
Format
Citation
What Treatments Are Effective for Symptomatic Benign Orthostatic Hypotension?
Title
What Treatments Are Effective for Symptomatic Benign Orthostatic Hypotension?.
Creator
Caporasco, Anthony, Chhabra, Ruchi, Qureshi, Hina, Rodríguez, Jose, Hitchcock, Kristin
Abstract/Description
Increased salt intake, compression stockings, and midodrine can reduce symptoms related to benign orthostatic hypotension. (SOR B, based on a single study of each intervention.) Counterpressure measures are safe, easy, reliable strategies to prevent syncope. (SOR A, based on 2 randomized controlled trials [RCTs] and a case series.) Drugs contributing to benign orthostatic hypotension should be discontinued or replaced if possible. (SOR C, based on expert opinion.)
Date Issued
2009
Identifier
FSU_migr_fmr-0014
Format
Citation
Does Dietary Fat Reduction Alter the Risk of Cardiovascular Events in Women?
Title
Does Dietary Fat Reduction Alter the Risk of Cardiovascular Events in Women?.
Creator
Smith, Joshua, Rodríguez, Jose
Abstract/Description
A decrease in dietary fat does not alter the risk of coronary heart disease (CHD), stroke, or cardiovascular disease (CVD) in postmenopausal women (SOR: B, based on a single RCT), nor does it significantly alter CHD in women aged 30 to 55. (SOR: B, based on a single cohort study.) However, CVD in women is epidemiologically linked to higher trans-fat consumption and lower polyunsaturated fat consumption.
Date Issued
2010
Identifier
FSU_migr_fmr-0031
Format
Citation