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Which infants need lumbar puncture for suspected sepsis?
(Family Physicians Inquiries Network, 2003)
of recommendation [SOR]: B, based on prospective and retrospective cohort studies). However, expert opinion suggests lumbar puncture on all infants aged 0 to 28 days with suspected sepsis, and all infants aged >2 months who are to receive empiric antibiotics (SOR: C...
Do imaging studies aid diagnosis of acute sinusitis?
(Family Physicians Inquiries Network, 2003)
Accurate diagnosis of acute sinusitis in both children and adults depends on the history and clinical examination of the patient. While the clinical signs and symptoms of acute sinusitis are often difficult to distinguish from viral upper...
What nonhormonal therapies are effective for postmenopausal vasomotor symptoms?
(Family Physicians Inquiries Network, 2003)
Regular exercise may reduce vasomotor symptoms of menopause (strength of recommendation [SOR]: C--single observational study). Soy products/isoflavones, either through diet or supplementation, may reduce the incidence of hot flushes (SOR: D...
Are drug therapies effective in treating Bell's palsy?
(Family Physicians Inquiries Network, 2003)
Early use of corticosteroid therapy results in less autonomic synkinesis and possibly improved rates of recovery in adults (strength of recommendation: C); there is no proven benefit in children (SOR: B). Adding acyclovir (Zovirax) to prednisone...
How should we manage infants at risk for group B streptococcal disease?
(Family Physicians Inquiries Network, 2003)
Asymptomatic term infants whose mothers received adequate intrapartum antibiotic prophylaxis (defined as intravenous penicillin or ampicillin at least 4 hours before delivery) for group B streptococcal disease do not need ...
Does physical therapy improve symptoms of fibromyalgia?
(Family Physicians Inquiries Network, 2003)
Physical therapy is minimally effective in the treatment of fibromyalgia, with immediate post-treatment improvement in pain and tender points, and both short- and longer-term improved self-efficacy (confidence in performing ...
Counseling or Antidepressants for Treating Depression?
(Family Physicians Inquiries Network, 2005)
Both antidepressant medications and psychologic treatment are beneficial for adult patients with mild to moderate depression, with no consistent evidence that one type of treatment is more effective than the other. [Strength ...
Metformin Therapy and Diabetes Prevention in Adolescents Who Are Obese
(Family Physicians Inquiries Network, 2007)
No studies have addressed the question of whether metformin reduces development of diabetes among adolescents who are obese. Metformin treatment in adolescents who are obese can modestly reduce risk factors for type 2 diabetes, including elevated...
Angiotensin blockade for diabetes: Monitor microalbuminuria?
(Family Physicians Inquiries Network, 2007)
No studies address whether continued screening for microalbuminuria once a patient is taking an angiotensin-converting enzyme (ACE) inhibitor or angiotensin-2 receptor blocker (ARB) improves outcomes. Indirect evidence and expert opinion suggest...
What is the best way to treat tinea cruris?
(Family Physicians Inquiries Network, 2006)
After clinical diagnosis and microscopic confirmation, tinea cruris is best treated with a topical allylamine or an azole antifungal (strength of recommendation: A, based on multiple randomized controlled trials [RCTs]). Differences in current...
Do TZDs increase the risk of heart failure for patients with diabetes?
(Family Physicians Inquiries Network, 2005)
retrospective cohort study). Still, patients starting any TZD should be warned of the possibility of CHF and should be monitored for its development. TZDs are contraindicated for patients with class III and IV CHF (SOR: C, based on expert opinion)....
Should liver enzymes be checked in a patient taking niacin?
(Family Physicians Inquiries Network, 2005)
No randomized trials directly address the question of frequency of liver enzyme monitoring with niacin use. Niacin use is associated with early and late hepatotoxicity (strength of recommendation [SOR]: B, based on incidence ...
How useful is high-sensitivity CRP as a risk factor for coronary artery disease?
(Family Physicians Inquiries Network, 2005)
risk for cardiovascular disease, with some evidence suggesting its use if the results of the test will alter treatment recommendations (strength of recommendation [SOR]: C, based on extrapolation of consistent level 2 studies). Research to date...
What are the indications for evaluating a patient with cough for pertussis?
(Family Physicians Inquiries Network, 2005)
Pertussis should be considered in infants with apnea or severe coughing illnesses of any duration, and in older children or adults with prolonged cough (eg, longer than 2 weeks), especially if accompanied by inspiratory whoop or household exposure...
Can we prevent splenic rupture for patients with infectious mononucleosis?
(Family Physicians Inquiries Network, 2005)
All patients with infectious mononucleosis should be considered at risk for splenic rupture since clinical severity, laboratory results, and physical exam are not reliable predictors of rupture (strength of recommendation [SOR]: B, case...
Does early detection of suspected atherosclerotic renovascular hypertension change outcomes
(Family Physicians Inquiries Network, 2005)
We found no evidence for changed outcomes from early detection of renal artery stenosis (RAS). Treatment of RAS in refractory hypertension modestly improves blood pressure control. There was a trend toward improved clinical outcomes but studies were...
What are effective therapies for Clostridium difficile- associated diarrhea?
(Family Physicians Inquiries Network, 2005)
select for colonization with vancomycin-resistant enterococci, leading the American College of Gastroenterology to recommend oral metronidazole as preferred therapy (SOR: C, expert opinion). They recommend therapy with vancomycin for those who...
What are the causes of hypomagnesemia?
(Family Physicians Inquiries Network, 2005)
, and malnutrition (strength of recommendation: C, based on expert opinion, physiology, and case series). Evidence suggests that magnesium deficiency is both more common and more clinically significant than generally appreciated....
Secondary Causes of Obesity
(Family Physicians Inquiries Network, 2011)
velocity, delayed puberty, or clinical signs and symptoms of endocrine abnormalities (e.g., hirsutism, truncal obesity, violaceous striae). (Strength of recommendation [SOR]: C, based on expert opinion.) Underlying metabolic and genetic causes of obesity...
What are effective treatments for oppositional and defiant behaviors in preadolescents?
(Family Physicians Inquiries Network, 2005)
strategies--including positive attending, ignoring, the effective use of rewards and punishments, token economies, and time out --to address clinically significant behavior problems. In addition to parent training, other psychosocial interventions...