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For children under 14 diagnosed with mild ADHD, pharmacological treatment should not be the first-line option. Non-pharmacological approaches are effective and have fewer side effects. Psychostimulants may cause adverse effects such as reduced appetite, insomnia, and headaches, without clear benefits in academic performance or family dynamics. Early medicalization introduces unnecessary risks and increases healthcare costs. Clinical decisions must prioritize evidence-based, cautious care ...

Choosing Wisely ® : Things we do for no reason

Choosing Wisely ® THINGS WE DO FOR NO REASON

Diverticulitis is a leading cause of hospitalization in the United States, with more than 400,000 emergency department visits and 200,000 hospital admissions annually, generating an estimated cost of $3.2 billion. Traditionally, it has been considered an infectious disease, leading to the routine use of antibiotics to prevent complications and reduce recurrence. However, recent studies have shown that most cases of uncomplicated acute diverticulitis can be managed without antibiotics without an ...

Choosing Wisely ® : Things we do for no reason

CHOOSING WISELY®: THINGS WE DO FOR NO REASON™

Alcohol use disorder (AUD) is a common cause of hospitalization, but access to pharmacological treatment remains very limited. Despite its effectiveness, less than 1% of patients with AUD in the United States receive evidence-based medication. Naltrexone, acamprosate, and disulfiram are the three FDA-approved drugs for AUD, but naltrexone is widely preferred due to its more convenient dosing and efficacy without the need for prior abstinence. However, concerns about its safety in patients with ...

Choosing Wisely ® : Things we do for no reason

CHOOSING WISELY®: THINGS WE DO FOR NO REASON™

Medical documentation has maintained a relatively constant structure since the 19th century, with specific linguistic patterns passed down within the medical profession. However, research in the medical humanities has identified that some terms used in medical records can contribute to the stigmatization of patients. These include verbs such as "denies," "insists," or "rejects," which can imply skepticism about the veracity of the information provided by the patient, in contrast to more ...

Choosing Wisely ® : Things we do for no reason

CHOOSING WISELY®: THINGS WE DO FOR NO REASON™

Ondansetron is a 5-HT3 receptor antagonist widely used in the hospital setting for the management of nausea and vomiting. Although it has been associated with QTc interval prolongation, the actual risk of clinically significant adverse events, such as torsades de pointes (TdP), is low. Despite this, many physicians routinely order ECGs before administering intravenous ondansetron due to concerns about its cardiovascular safety. The QTc represents the duration of ventricular repolarization and ...