Does turmeric relieve inflammatory conditions?

Limited evidence suggests that turmeric and its active compound, curcumin, are effective for rheumatoid arthritis and other inflammatory conditions (strength of recommendation [SOR]: C, primarily low-quality cohort studies with small patient numbers). Curcumin has shown limited benefit for patients with psoriasis, inflammatory bowel disease (IBS), inflammatory eye diseases, familial adenomatous polyposis, and kidney transplantation (SOR: B, small, short randomized controlled trials [RCTs]). No evidence indicates that curcumin helps patients with human immunodeficiency virus (HIV) (SOR: B, single RCT)

What screening tests should you use to evaluate a man with low testosterone?

Obtain a repeat morning testosterone level, as well as levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and prolactin to help understand the cause of low testosterone when there is a lack of adequate empiric evidence to guide evaluation, advise the experts. When low or normal FSH and LH levels accompany low testosterone, evaluation of the pituitary gland is recommended. Chromosomal studies are indicated in prepubertal males with low testosterone and elevated FSH and LH levels to assess for Klinefelter syndrome. Perform a semen analysis if fertility is an issue. Bone densitometry is indicated in men with chronic hypogonadism to identify increased risk of hip fracture (strength of all recommendations: C, consensus guidelines and disease-oriented evidence)

What is the best approach to the evaluation of resting tachycardia for an adult?

The best evidence about the diagnostic evaluation of resting tachycardias in adults is currently outlined by practice guidelines. 1 Initial evaluation includes clinical history, physical examination, and 12-lead electrocardiogram (ECG). If the initial evaluation suggests a sinus tachycardia with narrow QRS complexes and no identifiable secondary cause, a 24-hour Holter monitor is usually recommended (strength of recommendation: C, based on expert opinion)

Are any alternative therapies effective in treating asthma?

Yes, some are. Acupuncture relieves subjective symptoms of asthma and reduces medication use in mild to moderate asthma (strength of recommendation [SOR]: A, based on systematic review of randomized controlled trials [RCTs] of variable quality). Herbal medications, such as Ginkgo biloba, appear to improve lung function, while herbs such as Tylophora indica and Tsumura saiboku-to may decrease asthma symptoms (SOR: B, based on systematic review of RCTs with poor methodology). No evidence, however, supports the use of room air ionizers, manual therapy, homeopathy, or mind-body therapy for treatment of asthma (SOR: A, based on systematic reviews and meta-analyses of RCTs and individual RCTs)

Angiotensin blockade for diabetes: Monitor microalbuminuria?

No studies address whether continued screening for microalbuminuria once a patient is taking an angiotensin-converting enzyme (ACE) inhibitor or angiotensin-2 receptor blocker (ARB) improves outcomes. Indirect evidence and expert opinion suggest that it may be beneficial to continue microalbuminuria surveillance to assess response to therapy and monitor disease progression (strength of recommendation: C, based on expert opinion)

Which tests are the most useful for diagnosing PID?

No single test has adequate sensitivity and specificity to reliably identify pelvic inflammatory disease (PID) and thus help to spare women serious sequelae, including infertility (strength of recommendation [SOR]: B, based on systematic reviews of cohort studies and individual cohort studies)

What is the appropriate evaluation and treatment of children who are "toe walkers"?

The evaluation of toe-walking focuses on differentiating normal children from those with mild cerebral palsy. Gait analysis may be a useful diagnostic tool, but further investigation is needed to confirm its reliability (strength of recommendation [SOR]: C, based on case series). Observation alone is generally as successful as serial casting and surgery in decreasing the frequency of toe-walking at follow-up (SOR: C, based on case series)

What GI stress ulcer prophylaxis should we provide hospitalized patients?

Patients in intensive care unit (ICE) settings who are receiving prolonged mechanical ventilation (for >48 hours) or who have a coagulopathy or multiple organ dysfunction (especially renal failure) should receive stress ulcer prophylaxis. Current evidence does not support prophylaxis for non-ICU patients(strength of recommendation [SOR]: B, based on multiple systematic reviews)

What nutritional deficiencies and toxic exposures are associated with nail changes?

Infants with iron deficiency have a higher rate of koilonychia--concavity of the outer surface of the nail--(strength of recommendation [SOR]: C, one case-control study). Vitamin B12 deficiency is associated with various nail pigment changes that are reversible with treatment (SOR: C, case reports). Muehrcke's lines (transverse white bands that run parallel to the lunula) occur in a minority of patients with hypoalbuminemia. (SOR: C, one cross-sectional study). Fingernail clubbing has been found in most patients with kwashiorkor, or protein malnutrition (SOR: C, one cross-sectional study). Transplacental exposure to polychlorinated biphenyls (PCBs) and polychlorinated dibenzofurans (PCDFs) has been associated with nail deformities and color changes (SOR: C, one case-control study)

What's the best test for HSV-2 after exposure?

Enzyme-linked immunosorbent assay (ELISA ) tests based on herpes simplex virus 2's (HSV -2) glycoprotein G have demonstrated high sensitivity and specificity in determining seropositivity for HSV-2 antibodies (strength of recommendation [SOR]: C, based on cross-sectional studies). ELISA tests not based on glycoprotein G are also highly sensitive, but they are less specific for HSV-2 and are prone to false-positive results because of cross-reactivity with HSV -1 antibodies (SOR: C, based on cross-sectional studies)