It may, depending on the stage of labor and whether the woman has given birth previously. routine amniotomy doesn’t significantly reduce the duration of first-stage labor in either primiparous or multiparous women (strength of recommendation [sOr]: A, systematic review of several randomized, controlled trials [rCTs]); it slightly shortens secondstage labor in primiparous women only (sOr: A, sys...

Split tablets of lisinopril are as effective as whole tablets of the same dose for hypertension (strength of recommendation [SOR]: B, based on small randomized crossover study). Similarly, split tablets of atorvastatin, lovastatin, and simvastatin are no less effective for lowering cholesterol (SOR: B, based on retrospective cohort studies). Extended-release, enteric-coated, or tablets that can...

Low-carbohydrate diets raise high-density lipoprotein (HDL) cholesterol levels by approximately 10%; soy protein with isoflavones raises HDL by 3% (strength of recommendation [SOR]: C, based on meta-analysis of physiologic parameters). The Dietary Approaches to Stop Hypertension (DASH) diet and multivitamin supplementation raise HDL 21% to 33% (SOR: C, based on single randomized trial each meas...

Sorafenib (SOR) is the first-line treatment for hepatocellular carcinoma (HCC). However, its use is hindered by the recently expressed safety concerns. One approach for reducing SOR toxicity is to use lower doses in combination with other less toxic agents. Biochanin-A (Bio-A), a promising isoflavone, showed selective toxicity to liver cancer cells. We postulated that combining SOR and Bio-A co...

A dorsal penile nerve block (DPNB), ring block (RB), and eutectic mixture of local anesthetics (EMLA) all control pain effectively during neonatal circumcision (strength of recommendation [SOR]: A, systematic review). An RB may provide superior pain relief to DPNB and EMLA (SOR: B, limited-quality evidence). Using a Mogen clamp reduces pain by shortening procedure time (SOR: A, randomized contr...

This paper studies convergence analysis of a preconditioned inexact Uzawa method for nondi erentiable saddle-point problems. The SOR-Newton method and the SOR-BFGS method are special cases of this method. We relax the Bramble– Pasciak–Vassilev condition on preconditioners for convergence of the inexact Uzawa method for linear saddle-point problems. The relaxed condition is used to determine the...

Yes, a number of beta-blockers are effective in lowering blood pressure (strength of recommendation [sor]: a, multiple, consistent randomized controlled trials [rCTs]). Cardioselective beta-blockers do not alter lung function studies for patients with chronic obstructive pulmonary disease (CopD) or reversible airway disease (sor: a, meta-analysis of rCTs). propranolol and timolol have greater r...

No evidence supports one method over another in managing uncomplicated gastroesophageal reflux disease (GERD) for patients aged >65 years. For those with endoscopically documented esophagitis, proton pump inhibitors (PPIs) relieve symptoms faster than histamine H2 receptor antagonists (H2RAs) (strength of recommendation [SOR]: B, extrapolation from randomized controlled trials [RCTs]). Treating...

■ EVIDENCE-BASED ANSWER Stimulant medication therapy is the most effective treatment for attention deficit/hyperactivity disorder (ADHD) in children, producing significant improvements in symptoms and modest improvements in academic achievement (strength of recommendation [SOR]: A, based on multiple randomized controlled trials [RCTs]). Nonpharmacologic therapies, such as behavior therapy, scho...