Article
Do complementary agents lower HbA1c when used with standard type 2 diabetes therapy?
- Author:
- Monique M. Moona, MD
- Richard Smits, MD
- Joseph Kertesz, MA
- Albert Meyer, MD
- Leslie Mackler, MSLS
EVIDENCE-BASED ANSWER: No, there is no high-quality evidence that supports using complementary or alternative agents to lower hemoglobin A1c (...
News
When You Suspect ACS, Which Serologic Marker Is Best?
- Author:
- Jonathan Mitchell, MD
- Anne Mounsey, MD
- Leslie Mackler, MSLS
Article
When you suspect ACS, which serologic marker is best?
- Author:
- Jonathan Mitchell, MD
- Anne Mounsey, MD
- Leslie Mackler, MSLS
EVIDENCE-BASED ANSWER: Measurement of troponin levels provides the most sensitive and accurate serologic information in evaluating a patient with...
Article
Do oral contraceptives carry a significant risk of stroke for women with migraines?
- Author:
- Mallory McClester, MD
- Anne Mounsey, MD
- Leslie Mackler, MSLS
EVIDENCE-BASED ANSWER: Perhaps. Estrogen-containing oral contraceptives may raise the risk of ischemic stroke in women with migraine, particularly...
Article
Elevated troponin but no CVD: What’s the prognosis?
- Author:
- Tammy Mantzouris, MD
- Robert Gauer, MD
- Leslie Mackler, MSLS
EVIDENCE-BASED ANSWER: Patients with elevated troponin levels and chronic renal disease, pulmonary hypertension, pulmonary embolism, chronic...
Article
How should you treat a child with flat feet?
- Author:
- Madeleine Vanstory, MD
- M. Lee Chambliss, MD, MSPH
- Leslie Mackler, MSLS
EVIDENCE-BASED ANSWER: THAT DEPENDS on whether the pes planus (flatfoot) is flexible or rigid. Flexible flatfoot (FFF)—an arch that is flat only...
Article
What’s the best test for renal artery stenosis in patients with refractory hypertension?
- Author:
- Michael Stevenson, MD
- Brian Crownover, MD
- Leslie Mackler, MSLS
EVIDENCE-BASED ANSWER: Magnetic resonance angiography (MRA) and computed tomography angiography (CTA) are the most consistently accurate,...
Article
Does bed rest for preeclampsia improve neonatal outcomes?
- Author:
- Maria Linda Cabrera, MD
- Todd McDiarmid, MD
- Leslie Mackler, MSLS
EVIDENCE-BASED ANSWER: No. strict bed rest in the hospital for pregnant women with preeclampsia does not appear to lower rates of perinatal...
Article
Who should receive vertebroplasty?
- Author:
- Thomas J. Satre, MD
- Leslie Mackler, MSLS
EVIDENCE-BASED ANSWER: Percutaneous vertebroplasty has been used to treat aggressive vertebral hemangiomas, osteoporotic vertebral compression...
Article
What physical exam techniques are useful to detect malingering?
- Author:
- Steven Greer, MD
- Lee Chambliss, MD, MSPH
- Leslie Mackler, MSLS
EVIDENCE-BASED ANSWER: No examination technique objectively proves malingering (strength of recommendation [SOR]: C, expert opinion). Waddell’s...
Article
Can we prevent splenic rupture for patients with infectious mononucleosis?
- Author:
- Brett H. Foreman, MD
- Leslie Mackler, MSLS
EVIDENCE- BASED ANSWER: All patients with infectious mononucleosis should be considered at risk for splenic rupture since clinical severity,...
Article
How should a DEXA scan be used to evaluate bisphosphonate therapy for osteoporosis?
- Author:
- Peter G. Koval, PharmD, BCPS
- Lisa Easterling, PharmD
- Dawn Pettus, PharmD, CPP
- Leslie Mackler, MSLS
EVIDENCE-BASED ANSWER: If bone density is evaluated after initiating bisphosphonate drug therapy, it should be tested no earlier than 2 years (...
Article
What is the addiction risk associated with tramadol?
- Author:
- Todd McDiarmid, MD
- Leslie Mackler, MSLS
EVIDENCE-BASED ANSWER: Tramadol (Ultram, generic and with acetaminophen in Ultracet) carries a risk of substance abuse (strength of recommendation...
Article
Does quinine reduce leg cramps for young athletes?
- Author:
- Noelle Robertson, MD
- Wayne Hale, MD
- Leslie Mackler, MSLS
EVIDENCE-BASED ANSWER: Very little evidence exists regarding the use of quinine for cramps in young adult athletes. Quinine may be an effective...
Article
What is the best treatment for Osgood-Schlatter disease?
- Author:
- O. Josh Bloom, MD, MPH
- Leslie Mackler, MSLS
EVIDENCE-BASED ANSWER: Osgood-Schlatter disease is a common cause of pain and tenderness at the tibial tuberosity in active adolescents. It is...