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The article provides an answer to a question of which are the most effective combination drug therapies for hypertension.

The article provides an answer to a question of does the presence of a trained support person during labor decrease the likelihood of cesarean section (C-section).

The article provides an answer to a question on what are the risk factors and signs and symptoms associated with coccidioidomycosis.

The article presents a clinical commentary regarding the proper monitoring for patients having Barrett's esophagus. The author believes that patients having Barrett's esophagus are not prone to have esophageal cancer thus, an esophagogastroduodenoscopy every three years is an enough monitoring provided patients do not have occurrence of dysplasia.

The article discusses the concern on whether children can be benefited from blood pressure screening. It notes that the children may not be receiving benefit from screening of blood pressure, but could pay off for adults. It adds that children with high BP are more than 60 percent at risk of being hypertensive as young adult.

The article provides information concerning the evidence of increased risk for major bleeding in elderly patients who fall and are taking warfarin. Based on the study, the risk of intracranial hemorrhage from a fall is much smaller than the benefit gained from reducing risk of stroke in patients taking warfarin for atrial fibrillation. According to the author, major bleeding from a fall also occurs infrequently in patients with a therapeutic internal normalized ratio (INR). However, the author added that bleeding is more common in patients with a supratherapeutic INR.

The article focuses on the suitable treatment for impetigo, which include topical mupirocin, fusidic acid, and gentamicin. Topics discussed include the 2003 meta-analysis of 16 studies which evaluate the efficacy of topical antibiotics and placebo in treating impetigo in children and adults, 2008 randomized, double-blind study regarding retapamulin which reveals that it produces more clinical response compared to placebo, and efficacy of topical antibiotics compared to disinfectant solutions.

The article provides an answer to a question regarding the safety relief of low-back pain for pregnant women.

This article looks into the duration on the safety of expectant management in first-trimester miscarriage. It is noted that expectant management is successful within 2 to 6 weeks without increased complications in 80 percent to 90 percent of women with first-trimester incomplete spontaneous abortion and 65 percent to 75 percent of women with first-trimester missed abortion or anembryonic gestation. The evidence summary presented in this article gives clear information on outcomes that physicians can share with their patients; however, most women quickly know what they want regarding retained products of conception.

Insufficient evidence exists to determine which specific combinations most effectively decrease cardiovascular morbidity and mortality, although combinations of hypertension medications at lower doses generally reduce cardiovascular outcomes (stroke, coronary heart disease) more than monotherapy (strength of recommendation [SOR]: A, large meta-analyses).The combination of benazepril and amlodipine reduces the composite endpoint of cardiovascular events and deaths more than benazepril plus hydrochlorothiazide with similar rates of adverse effects (SOR: A, randomized controlled trial [RCT]).Combining an angiotensin converting enzyme inhibitor (ACE-I) with a thiazide, ß-blocker, or calcium channel blocker produces side effects similar to monotherapy, as does combining an angiotensin receptor blocker (ARB) with a thiazide or calcium channel blocker (SOR: A, meta-analyses). However, an ACE-I combined with an ARB increases the risk of renal complications and death more than monotherapy (SOR: A, RCT)..

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 measuring physiologic parameters). No other dietary interventions studied raise HDL (SOR: C, based on meta-analysis of physiologic parameters).

Some patients who have been diagnosed with Barrett's esophagus will develop dysplasia and, in some cases, esophageal carcinoma (strength of recommendation [SOR]: A, based on consistent cohort studies). Endoscopic surveillance is recommended for all patients with Barrett's esophagus as it is superior to other methods for detecting esophageal cancer (SOR: B, based on systematic review). The degree of dysplasia noted on biopsy specimens correlates with the risk of esophageal carcinoma development and should guide the frequency of subsequent evaluations (SOR: B, based on consistent cohort studies). The optimal frequency of endoscopy has yet to be determined in any randomized trial. Recommendations from the 2002 American College of Gastroenterology (ACG) Practice Guideline provide guidance as to the frequency of endoscopy surveillance but were not based on an explicit systematic review of the literature (SOR: C, based on expert opinion).

More than 80% of women with a first-trimester spontaneous abortion have complete natural passage of tissue within 2 to 6 weeks with no higher complication rate than that from surgical intervention (strength of recommendation [SOR]: A, based on multiple randomized controlled trials [RCTs] and cohort studies). Expectant management is successful within 2 to 6 weeks without increased complications in 80% to 90% of women with first-trimester incomplete spontaneous abortion and 65% to 75% of women with first-trimester missed abortion or anembryonic gestation (presenting with spotting or bleeding and ultrasound evidence of fetal demise) (SOR: B, based on multiple cohort studies). There is no difference in short-term psychological outcomes between expectant and surgical management (SOR: B, based on RCT). Women experiencing spontaneous abortion with unstable vital signs, uncontrolled bleeding, or evidence of infection should be considered for surgical evacuation (SOR: C, expert opinion).