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Take a structured clinical history in people with suspected asthma. Specifically, check for: wheeze, cough or breathlessness, and any daily or seasonal variation in these symptoms any triggers that ...
NICE
National Institute for Health and Clinical Excellence (NICE)
Examine people with suspected asthma to identify expiratory polyphonic wheeze and signs of other causes of respiratory symptoms, but be aware that even if examination results are normal the person may still have asthma.
ver más ... 2020No se recomienda el uso de terapia con progesterona durante el primer trimestre en mujeres con abortos espontáneos recurrentes inexplicables.
NICE
NICE
Women with previous pregnancy losses are at increased risk of miscarriage in subsequent pregnancies. Progesterone is essential for maintaining a healthy pregnancy and there is evidence that it is safe for both women and fetuses. A recent randomized controlled trial evaluated the effectiveness of micronized vaginal progesterone supplementation in women with 3 or more first trimester losses and did not show a benefit with the use of progesterone therapy during the first trimester, concluding that ...
ver más ... 2019Treatment with stereotactic surgery is recommended in patients with trigeminal neuralgia.
NICE
NICE
A systematic review was conducted to provide an objective summary of the published literature specific to the treatment of classical trigeminal neuralgia with stereotactic radiosurgery (SR) and to develop consensus guideline recommendations for the use of RS, endorsed by the International Society of Stereotactic Radiosurgery (SSRI). The literature is limited in its level of evidence, with only one comparative randomized trial (1 versus 2 isocenters) reported to date. At present, it can be ...
ver más ... 2019It is recommended to reduce the use of unnecessary drugs in frail patients, leaving only those for symptomatic treatment.
Choosing Wisely UK
Royal College of General Practitioners
When patients are particularly frail or in their last year of life, unless there is a clear preference otherwise by the patient or advocate, discuss with the patient and family/carers the option of decreasing the number of medicines to only those used for control of symptoms.
ver más ... 2019It is not recommended to treat adults with mild grade 1 hypertension with no other cardiovascular risk factors with hypertensive drugs, as it may have very little benefit.
Choosing Wisely UK
Royal College of General Practitioners
It is under discussion. Give antihypertensive drug therapy plus lifestyle advice for adults younger than 60 years with stage 1 hypertension and an estimated 10-year risk of less than 10%. Note that 10-year cardiovascular risk may underestimate the lifetime probability of developing cardiovascular disease. Discuss starting antihypertensive drug treatment, in addition to lifestyle advice, with adults aged under 80 with persistent stage 1 hypertension who have 1 or more of the following: -target ...
ver más ... 2019