Don’t use brain SPECT (Single photon emission computed tomography) with DAT (dopamine transporter) radiopharmaceuticals in the differential diagnosis of degenerative Parkinsonisms or to convince a patient with Parkinson’s disease that he/she is really affected with that disease.
Although some papers in the literature have shown mild to moderate striatal uptake differences between the several forms of degenerative Parkinsonisms at group level, there is a considerable overlap at individual level and thus it is very unlikely that brain SPECT...
Once the diagnosis is established, don’t prescribe systematic abdominal ultrasound checkup in asymptomatic patients with epathic angiomas < 30 mm in diameter.
Up to 5-20% of the population have epathic angiomas, furthermore only occasionally encountered in asymptomatic patients. Typical angiomas that are small in size can be entirely benign and don’t require any further ecographic control.
Don’t prescribe proton pump inhibitors (PPI) during steroid therapy or for long periods with patients that exhibit dyspeptic symptoms.
There’s no evidence supporting the systematic use of PPI on patients with functional dyspepsia or as prophylaxis during steroid therapy. The primary risk associated with suspending PPI during the course of acid-related disease is the return of symptoms. The...
Don’t repeat esofagogastroduodenoscopy (EGDS) for a patient that has been diagnosed with a gastroesophageal reflux disease, with or without hiatal hernia, in absence of new symptoms.
A diagnosis of gastroesophageal reflux disease is based on a combination of symptoms, feedback from antisecretory drugs, and diagnostic tests; EGDS allows for the diagnosis and eventual treatment of disease related complications; follow-up EGDS is only needed for...The campaign DOING MORE DOES NOT MEAN DOING BETTER – CHOOSING WISELY ITALY is promoted by Italy’s Slow Medicine
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