Clinical Inquiries, 2009
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Item Aspirin Use in Children for Fever or Viral Syndromes(Family Physicians Inquiries Network, 2009) Beutler, Anthony I.; Chesnut, Gregory T.; Mattingly, John C.; Jamieson, BarbaraAspirin should not be used to treat acute febrile viral illness in children. (Strength of Recommendation [SOR]: C, based on case- control studies). Although no causal link has been proven, data from case-control and historic cohort studies demonstrate an association between aspirin use and Reye syndrome.Item Do intercontraction intervals predict when a woman at term should seek evaluation of labor?(Family Physicians Inquiries Network, 2009) Mull, Courtney; McPherson, Vanessa; Zolotor, Adam J.; Kaufmann, LeonoraA reduction in the intercontraction interval is associated with active labor (strength of recommendation [SOR]: B, cohort study). Most primigravidas who have had regular contractions for 2 hours and multigravidas who have had regular contractions for 1 hour haven't transitioned into the active phase of labor (SOR: B, cohort study).Item What does the evidence tell us about treating very-high-risk patients to an LDL <70 mg/dL?(Family Physicians Inquiries Network, 2009) Nelson, Carrie; Hitchcock, Kristin; Bohlen, James A.No studies directly compare low-density lipoprotein (LDL) levels <70 mg/dL to levels of 71 to 100 mg/dL in very-high-risk patients. However, no evidence suggests a "floor" for LDL cholesterol levels beyond which further reductions of heart disease risk can't be achieved (strength of recommendation [SOR]: A, systematic reviews of randomized controlled trials [RCTs]). The target LDL cholesterol of <70 mg/dL is based on data extrapolated from RCTs (SOR: B).Item What's the best way to monitor low-risk patients with a history of differentiated thyroid cancer?(Family Physicians Inquiries Network, 2009) Albrecht, Angela M.; Paulson, Christopher P.; Kovach, Fran E.Recombinant human thyrotropin (rhTSH)-stimulated serum thyroglobulin (Tg) level alone is sufficient to monitor for recurrent disease in low-risk patients with a history of differentiated thyroid cancer (DTC) (strength of recommendation [SOR] A, meta-analysis). Low-risk patients are defined as patients who have undergone total thyroidectomy and radioactive iodine (I131) remnant ablation therapy and show no clinical evidence of recurrent disease.Item Which strategies work best to prevent obesity in adults?(Family Physicians Inquiries Network, 2009) Boltri, John M.; House, Alice A.; Nelson, Roxanne M.Regular physical activity decreases long-term weight gain (strength of recommendation [SOR]: B, 2 high-quality, randomized controlled trials [RCTs]). Decreasing fat intake (SOR: B, 1 high-quality systematic review) and increasing fruit and vegetable consumption (SOR: B, 1 high-quality RCT) also may decrease weight gain. Combined dietary and physical activity interventions prevent weight gain (SOR: B, 1 high-quality systematic review).