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Platelet-rich plasma injection for rotator cuff disease
(Family Physicians Inquiries Network, 2020)
Clinical Inquiries question: Is platelet-rich plasma (PRP) injection an effective treatment for rotator cuff disease? Evidence-based answer: In non-operative treatment of rotator cuff injuries, PRP injection did not improve functional outcomes...
Does caffeine intake during pregnancy affect birth weight?
(Family Physicians Inquiries Network, 2016)
more than 300 mg of caffeine per day is associated with a clinically trivial, and statistically insignificant (less than 1 ounce), reduction in birth weight, compared with consuming no caffeine (strength of recommendation: B, randomized controlled trial...
First- or second-generation antihistamines: which are more effective at controlling pruritus?
(Family Physicians Inquiries Network, 2004)
For urticarial itch, first- and second-generation antihistamines have similar clinical benefit and are superior to placebo (strength of recommendation [SOR]: A, systematic review of randomized trials [RCT]). For itch related to atopic dermatitis...
Can transvaginal ultrasound detect endometrial disease among asymptomatic postmenopausal patients?
(Family Physicians Inquiries Network, 2004)
Transvaginal ultrasound should not replace endometrial biopsy for detection of endometrial disease among asymptomatic postmenopausal patients. Endometrial biopsy has been considered a standard for the clinical diagnosis of endometrial disease among...
Time to stop glucosamine and chondroitin for knee OA?
(Family Physicians Inquiries Network, 2018)
Time to stop glucosamine and chondroitin for knee OA? Prior studies provided conflicting results regarding the efficacy of these medications. This study offers evidence for discontinuing them. Practice changer: Tell patients ...
Deliver or wait with late preterm membrane rupture?
(Family Physicians Inquiries Network, 2016)
of clinical indications for delivery, consider expectant management in women with premature rupture of membranes in late preterm stages (34 weeks to 36 weeks, 6 days). Stength of recommendation: B: Based on one well-designed randomized controlled trial: Morris...
A better approach to the diagnosis of PE
(Family Physicians Inquiries Network, 2019)
angiography when evaluating patients for suspected pulmonary embolism unless: (1) the patient has a d-dimer concentration ≥ 1000 ng/mL; or (2) the patient has a d-dimer concentration ≥ 500 ng/mL, PLUS: (A) clinical signs of deep vein thrombosis, (B) hemoptysis...
What interventions reduce the risk of contrast nephropathy for high-risk patients?
(Family Physicians Inquiries Network, 2005)
Several interventions may reduce the risk of contrast nephropathy for high-risk patients; however, most evidence uses surrogate markers for clinically relevant outcomes. Because dehydration is a risk factor for developing contrast nephropathy...
Are antibiotics effective in preventing pneumonia for nursing home patients?
(Family Physicians Inquiries Network, 2004)
(SOR: B, based on individual randomized controlled trial); pneumococcal vaccination of residents (SOR: B, based on randomized, nonblinded clinical trials and consistent case-control studies). Two other suggested interventions have not been extensively...
No pain, if you've got game
(Family Physicians Inquiries Network, 2021)
No pain, if you've got game. Allowing children to engage in active distraction techniques--such as playing a video game--during venipuncture can lead to reduced pain and anxiety. PRACTICE CHANGER: Employ active distraction, ...
Antidepressants for the Treatment of Insomnia in Patients with Depression
(Family Physicians Inquiries Network, 2011)
There is no single antidepressant or class of antidepressants that is most effective for the treatment of insomnia in patients with depression. The use of antidepressant medications can have a positive impact on sleep ...
Is the long-term use of proton pump inhibitors safe?
(Family Physicians Inquiries Network, 2004)
Long-term use of proton pump inhibitors (PPIs) appears safe, resulting in no clinically relevant adverse effects (strength of recommendation: B, based on nonsystematic reviews, cohort studies, or low-quality randomized controlled trials...
Which oral antifungal is best for toenail onychomycosis?
(Family Physicians Inquiries Network, 2007)
Terbinafine, 250 mg taken daily for 12 weeks, is the best regimen for toenail onychomycosis due to better clinical and mycologic cure rates, tolerability, and cost effectiveness (strength of recommendation [SOR]: A, meta-analyses)....
Azithromycin for PID beats doxycycline on all counts
(Family Physicians Inquiries Network, 2007)
Outpatient treatment of patients with mild pelvic inflammatory disease, using 1g of azithromycin weekly for 2 weeks, combined with 250mg of ceftriaxone intramuscularly on the first day, is superior to the current recommended ...
Ovarian torsion
(Family Physicians Inquiries Network, 2012)
This issue of eMedRef provides information to clinicians on the pathophysiology, diagnosis, and therapeutics of ovarian torsion.
What are hospital admission criteria for infants with bronchiolitis?
(Family Physicians Inquiries Network, 2006)
Clinical judgment remains the gold standard for hospital admission of infants with bronchiolitis, and it cannot be replaced by objective criteria (strength of recommendation [SOR]: B, based on prospective and retrospective cohort and retrospective...
Do oral decongestants have a clinically significant effect on BP in patients with hypertension?
(Family Physicians Inquiries Network, 2017)
Q: Do oral decongestants have a clinically significant effect on BP in patients with hypertension? Evidence-based answer: It is unclear. Pseudoephedrine causes an average increase of 1.2 mm Hg in systolic blood pressure (BP) in patients...
This antiemetic may help kids skip that trip to the hospital
(Family Physicians Inquiries Network, 2009)
Give oral ondansetron to children with acute gastroenteritis and moderate dehydration who are unable to tolerate oral rehydration to reduce the vomiting and avoid the need for intravenous (IV) hydration or hospitalization. ...
It's time to use an age-based approach to D-dimer
(Family Physicians Inquiries Network, 2014)
Use an age-adjusted D-dimer cutoff (patient's age in years [multiplied by] 10 mcg/L) for patients over age 50 years when evaluating for venous thromboembolism (VTE); it reduces false positives without substantially increasing ...
Can sleep apnea be accurately diagnosed at home?
(Family Physicians Inquiries Network, 2019)
Can sleep apnea be accurately diagnosed at home? A recent study says Yes, and that it offers advantages: it can be scheduled faster, is less expensive, and is more acceptable to many patients than lab testing. PRACTICE ...