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Dipstick urinalysis for the diagnosis of acute UTI
(Family Physicians Inquiries Network, 2013)
Approximately two-thirds of women who present with classic symptoms of acute UTI have bacterial infection of the bladder. Dipstick urinalysis moderately improves the accuracy of clinical symptoms in establishing or excluding ...
Pharmacologic therapy for vitamin D deficiency
(Family Physicians Inquiries Network, 2013)
Cholecalciferol (vitamin D3) supplementation should be used for vitamin D repletion because it may be more effective in preventing nonvertebral fractures. (Strength of Recommendation [SOR]: B, based on subgroup analysis of randomized controlled...
Screening for hepatocellular carcinoma in patients with hepatitis C virus infection
(Family Physicians Inquiries Network, 2013)
screening sensitivity, but may be limited by cost and availability. (SOR: C, based on retrospective case series.) Combined testing with AFP measurement and ultrasonography improves sensitivity but decreases specificity....
Management of ADHD in preschool-aged children
(Family Physicians Inquiries Network, 2013)
Behavior therapy interventions, such as parent training, are first-line treatment for ADHD in preschool-aged children (three to five years of age). (Strength of Recommendation [SOR]: B, based on a systematic review of a ...
An obesity remedy for diabetes
(Family Physicians Inquiries Network, 2013)
Consider bariatric surgery for patients with diabetes who are obese; surgery is associated with higher remission rates than medical therapy, regardless of the amount of weight lost. Stength of recommendation: B: Based on ...
Do oral contraceptives carry a significant risk of stroke for women with migranes?
(Family Physicians Inquiries Network, 2013)
Evidence-based answer: Estrogen-containing oral contraceptives may raise the risk of ischemic stroke in women with migraine, particularly migraine with aura (strength of recommendation [SOR]: C, small case-control studies with methodological flaws...
Updated USPSTF screening guidelines may reduce lung cancer deaths
(Family Physicians Inquiries Network, 2022)
By nearly doubling the number of patients eligible for screening, as many as 60,000 US lives may be saved--but concerns may limit acceptance....
What is the best initial treatment for venous stasis ulcers?
(Family Physicians Inquiries Network, 2013)
, single RCT) and pentoxifylline (SOR: A, systematic review of RCTs) improve healing rates whereas antibiotics don't (SOR: A, systematic review of RCTs). Cadexomer iodine, a topical antiseptic, improves ulcer healing but may not be feasible in most clinical...
Is combination pharmacotherapy effective for patients with acute depression?
(Family Physicians Inquiries Network, 2023-04)
Use a combination of a presynaptic α2-autoreceptor antagonist (eg, mirtazapine or trazodone) and a monoamine reuptake inhibitor (eg, selective serotonin reuptake inhibitor [SSRI], serotonin-norepinephrine reuptake inhibitor ...
Can early introduction of gluten reduce risk of celiac disease?
(Family Physicians Inquiries Network, 2022)
This UK study revealed the benefits of introducing gluten at age 4 months.
Consider this Rx for patients with high triglycerides?
(Family Physicians Inquiries Network, 2020)
A daily dose of this prescription fish oil may be worth a trial in light of the cardiovascular benefits it affords statin-treated patients with high triglycerides. PRACTICE CHANGER: Consider icosapent ethyl, 2 g twice daily, for secondary prevention...
Sterile or non-sterile gloves for minor skin excisions?
(Family Physicians Inquiries Network, 2015)
Sterile or non-sterile gloves for minor skin excisions? Non-sterile gloves are just as effective as sterile gloves in preventing surgical site infection after minor skin surgeries. PRACTICE CHANGER: Consider using non-sterile ...
Steroids during late preterm labor: better later than never
(Family Physicians Inquiries Network, 2017)
at risk of preterm delivery, even if they are 36 weeks, 6 days-pregnant, because steroids may reduce respiratory complications in the newborn with minimal risk for neonatal or maternal complications....
Smoking cessation counseling: What do physicians really say and how do they say it?
(University of Missouri--Kansas City, 2012)
The U.S. Public Health Service Clinical Practice Guideline recommends that
physicians provide tobacco cessation interventions to their patients at every visit. While
many studies have examined the extent to which physicians ...
Efficacy of a low-carbohydrate or ketogenic diet in preventing patient morbidity and mortality
(Family Physicians Inquiries Network, 2020)
Clinical Inquiries question: What is the efficacy of a low-carbohydrate or ketogenic diet in the prevention of patient morbidity and mortality? Evidence-based answer: Ketogenic diets can reduce seizure incidence in refractory ...
Resistant hypertension? Time to consider this fourth-line drug
(Family Physicians Inquiries Network, 2016)
Resistant hypertension? Time to consider this fourth-line drug For most adults with resistant hypertension, spironolactone is superior to doxazosin and bisoprolol as an adjunct to triple therapy. Practice changer: When a ...
Does niacin decrease cardiovascular morbidity and mortality in CVD patients?
(Family Physicians Inquiries Network, 2018)
Q: Does niacin decrease cardiovascular morbidity and mortality in CVD patients? A: No. Niacin doesn't reduce cardio- vascular disease (CVD) morbidity or mortality in patients with established disease (strength of recommendation [SOR]: A, meta...
A Quack on Trial: Advertising and Education in Missouri's Medical Marketplace, 1850--1890
(2014-09-30)
physicians like Galen Bishop struggled with their organizational minded counterparts, like George Catlett, over the ethical soul of American medicine. Should medicine be an exclusive, well-regulated, morally certified gentlemen's practice? Or, should...
Decision-making in pediatric hematopoeitic cell transplantation
(University of Missouri--Columbia, 2018)
. The decision of whether or not to pursue HCT involves uncertainty and risk. Pediatric patients with SCD and their families undergo a decision-making process distinct from patients with childhood cancer. Patients with sickle cell disease (SCD) realize...
How safe and effective is ondansetron for nausea and vomiting in pregnancy?
(Family Physicians Inquiries Network, 2019)
(strength of recommendation [SOR]: B, randomized controlled trial [RCT]). For moderate to severe nausea and vomiting, intravenous (IV) ondansetron is at least as effective as IV metoclopramide and may cause fewer adverse reactions (SOR: B, RCTs). Disease...