Suspect an eating disorder? Suggest CBT

Refer patients with eating disorder not otherwise specified (NOS) for cognitive behavioral therapy. CBT, which has proven to be the most useful behavioral treatment for bulimia, has now been shown to be effective for patients in the NOS category. Stength of recommendation: B: 1 high-quality, randomized controlled trial (RCT)

Acute gout: Oral steroids work as well as NSAIDs

Use a short course of oral steroids (prednisone 30-40mg/d for 5 days) for treatment of acute gout when nonsteroidal anti-inflammatory drugs (NSAIDs) are contraindicated. Steroids are also a reasonable choice as first-line treatment. Stength of recommendation: B: 2 good-quality, randomized controlled trials (RCTs)

Let them eat nuts -- this snack is safe for diverticulosis patients

Tell patients with diverticular disease that they can eat nuts, corn, and popcorn without fear. There is no truth to the long-held belief that these foods increase the risk of complications. Strength of recommendatin: B: A large cohort study

Use anesthetic drops to relieve acute otitis media pain

Use 3 drops of topical 2% lidocaine drops or benzocaine to provide rapid pain relief for children with acute otitis media. Stength of recommendation: B: 2 good-quality, randomized controlled trials

This obscure herb works for the common cold

Offer patients Pelargonium sidoides (30 drops 3 times a day) to reduce the severity and duration of common cold symptoms and to get patients back to work sooner. Stength of recommendation: B: A single well-designed randomized controlled trial

Bisphosphonate therapy: When not to monitor BMD

After starting patients on bisphosphonates for osteoporosis, wait at least 3 years before ordering a repeat dual-energy x-ray absorptiometry (DXA) scan. Stength of recommendation: C: Based on a secondary analysis of a large randomized controlled trial

Vertebroplasty for osteoporotic fracture? Think twice

Think twice before recommending vertebroplasty (VP) for symptomatic osteoporotic compression fractures. New studies suggest that it has little benefit; thus, VP should be considered only after other, more conservative options fail. Stength of recommendation: A: Consistent, high-quality randomized controlled trials (RCTs)

Can metformin undo weight gain induced by antipsychotics?

Recommend metformin 250mg 3 times a day, along with lifestyle modifications, to promote weight loss and decrease insulin resistance in patients who gain more than 10% of their pretreatment body weigh on antipsychotic medications. Stength of recommendation: B: Based on a single, well-designed, randomized controlled trial

Patients insist on antibiotics for sinusitis? Here is a good reason to say no

Stop prescribing antibiotics for adults with a clinical diagnosis of acute sinusitis, unless the patient has severe symptoms Antibiotics have little if any positive effects on the severity and duration of symptoms, and they cause adverse effects and create unnecessary expense. Stength of recommendation: A: Based on a meta-analysis of 9 randomized trials in primary care practice

Saline irrigation spells relief for sinusitis sufferers

Recommend nasal irrigation to patients with chronic rhinosinusitis. Large-volume, low- pressure saline irrigation decreases the severity and frequency of symptoms. Stength of recommendation: B: Single well-done randomized controlled trial (RCT)