Clinical inquiries. How do we evaluate a marginally low B12 level?
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to Joan Nashelsky.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Of the different strategies available for managing cervical intraepithelial neoplasia grade 1 (CIN1), testing for high-risk subtypes of the human papillomavirus (hr-HPV) DNA at 12 months has the highest sensitivity for predicting the development of CIN2 or CIN3 and leads to the lowest rate of referral to repeat colposcopy. If the hr-HPV DNA test result is negative at 12 months, then the patient may return to routine cytology screening. If the hr-HPV DNA test result is positive, the patient should undergo repeat colposcopy.
Tricyclic antidepressants and intensive multidisciplinary programs are moderately effective for reducing chronic back pain; tricyclics are also effective for diabetic neuropathy and irritable bowel syndrome (strength of recommendation [SOR]: A, meta-analyses and multiple small randomized controlled trials). Cognitive therapies are modestly effective for reducing pain in the following: chronic back pain, other chronic musculoskeletal disorders including rheumatoid arthritis (SOR: B, multiple meta-analyses with significant heterogeneity), and for chronic cancer pain (SOR: B, 1 meta-analysis of various quality studies).
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Tissue adhesives are effective and yield results comparable to those with conventional suturing of superficial, linear, and low-tension lacerations. The cosmetic outcome is similar; wound complications, such as infection and dehiscence, may be lower with tissue adhesives. Wound closure of superficial lacerations by tissue adhesives is quicker and less painful compared with conventional suturing (strength of recommendation: A, systematic reviews of randomized trials).
Explore the source record for details and available documents.
Explore the source record for details and available documents.
No studies evaluate the commonly used indications for bariatric surgery. Consensus guidelines suggest that the surgical treatment of obesity should be reserved for patients with a body-mass index (BMI) >40 kg/m(2) or with BMI >35 kg/m(2) and 1 or more significant comorbid conditions, when less invasive methods of weight loss have failed and the patient is at high risk for obesity-associated morbidity and mortality (strength of recommendation: C, based on consensus guidelines).