The Journal of family practice
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BENZODIAZEPINES REMAIN THE FIRST-LINE REGIMEN FOR ALCOHOL WITHDRAWAL SYNDROME (AWS) AND ARE THE ONLY CLASS MORE EFFECTIVE THAN PLACEBO FOR REDUCING SEIZURE (STRENGTH OF RECOMMENDATION [SOR]: B, BASED ON 3 MEDIUM-QUALITY RANDOMIZED CONTROLLED TRIALS [RCTS]). ANTICONVULSANTS ARE NO MORE EFFECTIVE THAN PLACEBO AT REDUCING SEIZURES (SOR: B, BASED ON 10 MODERATE-QUALITY RCTS). ⋯ CARBAMAZEPINE ALSO REDUCES WITHDRAWAL SYMPTOMS (SOR: B, BASED ON 3 RCTS). EVIDENCE OF BENZODIAZEPINE SUPERIORITY TO OTHER DRUGS WITH RESPECT TO SAFETY IS LACKING (SOR: A, BASED ON A META-ANALYSIS).
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YES, TO SOME DEGREE-BUT IT IS OF UNCERTAIN CLINICAL SIGNIFICANCE. OVER A PERIOD OF 6 MONTHS, METFORMIN MODESTLY REDUCED WEIGHT (-2.1 KG) AND BODY FAT MASS (-1.9%), BUT NOT BODY MASS INDEX (BMI) OR LEAN BODY MASS, IN ADOLESCENTS WHO WERE OVERWEIGHT OR OBESE. THIS IS COMPARABLE TO LIFESTYLE INTERVENTIONS (DIET AND EXERCISE) SUPPORTED WITH > 26 HOURS OF COUNSELING, WHICH MODESTLY IMPROVED BMI BUT NOT WEIGHT. (STRENGTH OF RECOMMENDATION [SOR]: A, BASED ON A LARGE META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS [RCTS] OF VARIABLE QUALITY).
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This review lists the questions to ask to obtain important diagnostic clues and provides an algorithm for evaluating palpitations when the initial Dx is not evident on EKG.