Does a short symptom checklist accurately diagnose ADHD?

Several abbreviated checklists perform well in distinguishing children with attention deficit/ hyperactivity disorder (ADHD) from those without ADHD under ideal conditions and in research settings. While many guidelines and experts recommend using these checklists as an efficient method to collect data from multiple sources (strength of recommendation: B, based on extrapolation from cohort studies to define test characteristics and consensus opinion), experts point out the subjective nature of responses on behavior rating scales, and the limitations in using checklists as the sole source of information

Does combining aspirin and warfarin decrease the risk of stroke for patients with nonvalvular atrial fibrillation?

Adjusted-dose warfarin (international normalized ratio [INR]=2.0-3.0) remains the most efficacious antithrombotic regimen for the primary and secondary prevention of cardioembolic stroke in high-risk patients with nonvalvular atrial fibrillation (NVAF) (strength of recommendation [SOR]: A, based on randomized controlled trials). Aspirin therapy at a dose of 75 to 325 mg reduces the risk of stroke to a lesser degree and may be useful for low-risk patients with NVAF or patients at high risk for bleeding (SOR: A, based on randomized controlled trials). Combination therapy with low, fixed-dose warfarin (1-2 mg) and aspirin has not been shown to be superior to aspirin therapy alone. Moreover, this combination appears to be inferior to adjusted-dose warfarin (SOR: A, based on randomized controlled trials). To date, no clinical trials have investigated the efficacy and safety of combining adjusted-dose warfarin and aspirin for the prevention of stroke from NVAF

What medication best prevents migraine in children?

Propranolol, valproic acid, and amitriptyline are effective prophylaxis for migraine in children to varying degrees, are widely available, and have a reasonable safety profile (strength of recommendation [SOR]: B, based on either single randomized controlled trial, prospective or retrospective cohort studies, or trials with conflicting evidence). Flunarizine and nimodipine have the best evidence of benefit in children; however, availability, cost, and side effects limit their usefulness (SOR: B, based on multiple small randomized controlled trials)

Is the long-term use of proton pump inhibitors safe?

Long-term use of proton pump inhibitors (PPIs) appears safe, resulting in no clinically relevant adverse effects (strength of recommendation: B, based on nonsystematic reviews, cohort studies, or low-quality randomized controlled trials). No evidence clearly links PPIs to gastric cancer or carcinoid, enteric infections, or significant nutrient malabsorption

What causes a low TSH level with a normal free T4 level?

Subclinical hyperthyroidism (SCH) is defined as a low thyroid-stimulating hormone (TSH) level with normal free T4 and free T3 levels in patients without specific symptoms of hyperthyroidism. There is no evidence that treating SCH results in improved cardiovascular outcomes and evidence is insufficient that it improves neuropsychiatric outcomes (strength of recommendation [SOR]: C). Bone mineral density may be increased with treatment of SCH (SOR: B, based on one randomized clinical trial)