Generation and description of a class of random processes

Generation of possibly nonstationary random process with specified autocorrelation functio

Are drug therapies effective in treating Bell's palsy?

Early use of corticosteroid therapy results in less autonomic synkinesis and possibly improved rates of recovery in adults (strength of recommendation: C); there is no proven benefit in children (SOR: B). Adding acyclovir (Zovirax) to prednisone therapy may improve recovery rates compared with prednisone alone (SOR: C). The results of 1 nonblinded study indicate that intramuscular methylcobalamin (vitamin B12) used alone or in combination with prednisone may shorten time to recovery (SOR: C)

What is the best duration of steroid therapy for contact dermatitis (rhus)?

Scant evidence exists for the best duration of steroid therapy for contact dermatitis due to plants (rhus). Review articles recommend 10 to 21 days of treatment with topical or oral corticosteroids for moderate to severe contact dermatitis due to plants (strength of recommendation [SOR]: C, based on review articles). The primary reason given for the duration of 2 to 3 weeks is to prevent rebound dermatitis

Does neonatal circumcision decrease morbidity?

Evidence suggests that neonatal circumcision decreases the incidence of childhood urinary tract infections, phimosis, paraphimosis, balanitis and other genital dermatoses, invasive penile cancer, and the sexually transmitted diseases human papilloma virus (HPV) and HIV (strength of recommendation [SOR]: B, based on case control and cohort studies). The benefits of decreased incidence of HPV and HIV infections go beyond the index patient and have public health implications on the transmission of these diseases (SOR: B). Further, a decrease in HPV incidence and transmission may lead to a lower incidence of cervical cancer (SOR: B). While there appears to be some evidence for reduced morbidity with routine circumcision, decisions regarding routine neonatal circumcision requires balancing risks and benefits of the procedure with the alternatives in the context of social, familial, and religious beliefs

Does a low-salt diet reduce morbidity and mortality in congestive heart failure?

No randomized controlled trials (RCTs) have addressed the independent role of sodium restriction in the morbidity or mortality of congestive heart failure. However, current guidelines recommend sodium restriction for secondary prevention of congestive heart failure exacerbation.(Grade of recommendation: D.) Clinical trials of multifactorial, nondrug interventions have shown an association of sodium restriction with reduced morbidity and improved quality of life in some populations with congestive heart failure.(Grade of recommendation: C.

When should COX-2 selective NSAIDs be used for osteoarthritis and rheumatoid arthritis?

Cyclo-oxygenase-2 (COX-2) selective nonsteroidal anti-inflammatory drugs (NSAIDs) are as effective as acetaminophen and nonselective NSAIDs in treating of osteoarthritis, and are equally effective in reducing pain and inflammation and improving of joint function for patients with rheumatoid arthritis, when compared with nonselective NSAIDs. The COX-2 selective NSAIDs also have a better gastrointestinal safety profile in short-term (6-12 month) treatment (strength of recommendation [SOR]: A, based on meta-analysis of randomized controlled trials withpatient-oriented outcomes)

What is the best approach to goiter for euthyroid patients?

A detailed history and exam, confirmation of euthyroid status, and imaging when appropriate is the best approach to euthyroid patients with thyroid enlargement in regions where goiters are not endemic. Ultrasound imaging is recommended in any case of diagnostic uncertainty. Evaluate dominant or suspicious nodules further, while diffuse goiters without symptoms require no further evaluation and can be followed clinically (strength of recommendation [SOR]: C, expert opinion)

Do acetaminophen and an NSAID combined relieve osteoarthritis pain better than either alone?

Combining nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen for short courses provides more relief of pain in osteoarthritis without an increase in side effects (strength of recommendation [SOR]=B). Combining acetaminophen at 4 g/d with an NSAID can also decrease the daily dose of NSAID required for pain relief, thus reducing the potential risk from higher-dose NSAID therapy (SOR=B). Over the long term, however, this combination may increase the risk of upper gastrointestinal (GI) bleeding more than that conferred by the NSAID alone (SOR=B). If combination therapy is necessary, limiting the dose of acetaminophen to ≤2 g/d minimizes gastrointestinal toxicity. Acetaminophen alone at the lowest dose to provide pain relief is the safest pharmacologic choice for patients with osteoarthritis

Who should have colposcopy?

Colposcopy is the preferred test in the work-up of patients with abnormal cervical cytology: Low-grade squamous intraepithelial lesion (LSIL): mild dysplasia ; High-grade squamous intraepithelial lesion (HSIL): moderate to severe dysplasia. ; Atypical squamous cells of undetermined significance (ASC-US) with high-risk human papillo-mavirus (HPV) DNA ; Atypical squamous cells, cannot rule out HSIL (ASC-H) ; Atypical glandular cells (AGC) ; Adenocarcinoma in situ (AIS). Colposcopy is also recommended for patients with symptoms suggestive of cervical cancer (abnormal appearance of the cervix, persistent and undiagnosed vaginal discharge or bleeding) regardless of cytology results, and in the follow-up of patients previously treated for cervical dysplasia (Grade of Recommendation: B). Colposcopy is not recommended for routine cervical cancer screening

What is the prognosis of postherpetic neuralgia?

Postherpetic neuralgia occurs rarely among patients aged 70 years, 25% had some pain at 3 months, but only 10% had pain at 1 year, and none had severe pain. Only a few patients have pain that persists for years (strength of recommendation: A, based on a well-done prospective cohort study)