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What's the best approach to diagnosing food allergies in infants?
(Family Physicians Inquiries Network, 2010)
A well-designed oral food challenge (OFC) is the most reliable diagnostic test for infants whose clinical history and physical examination suggest a specific food allergy (strength of recommendation [SOR]: C, consensus guidelines)....
Does chocolate have cardiovascular benefits?
(Family Physicians Inquiries Network, 2010)
Eating chocolate reduces blood pressure in the short term (strength of recommendation [SOR]: B, a meta-analysis and individual randomized controlled trials [RCTs]). No studies, however, have evaluated the long-term ...
Glycemic Control in Patients with Type 2 Diabetes
(Family Physicians Inquiries Network, 2007)
There is no clearly superior oral agent for glycemic control in patients with type 2 diabetes. (Strength of Recommendation [SOR]: C) Metformin (Glucophage) has shown additional benefit when compared with other treatments (including insulin...
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 ...
Does exercise alleviate symptoms of depression?
(Family Physicians Inquiries Network, 2010)
Exercise reduces patient-perceived symptoms of depression when used as monotherapy (strength of recommendation [SOR]: B, meta-analysis of randomized controlled trials [RCTs] with significant heterogeneity). It relieves ...
What's best when a patient doesn't respond to the maximum dose of an antidepressant?
(Family Physicians Inquiries Network, 2010)
(strength of recommendation [SOR]: C, expert opinion)....
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...
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...
When should you suspect community-acquired MRSA? How should you treat it?
(Family Physicians Inquiries Network, 2009)
There are no clinical or epidemiologic features that will help you to clearly distinguish community-acquired methicillin-resistant Staphylococcus aureus infections (CA-MRSA) from methicillin-sensitive (CA-MSSA) infections (strength of recommendation...
Sleep apnea in adults: How accurate is clinical prediction?
(Family Physicians Inquiries Network, 2009)
Questionnaires, physical examination, and clinical prediction rules estimate the pretest probability of obstructive sleep apnea hypopnea syndrome (OSAHS), but are not specific enough to make the diagnosis (strength of recommendation [SOR]: B, meta...
Which patients benefit from lowering LDL to <100 mg/dL?
(Family Physicians Inquiries Network, 2010)
Patients who have coronary heart disease (CHD) or are at high risk for CHD should aim for a low-density lipoprotein (LDL) target of <100 mg/dL. An LDL target of <70 mg/dL is an option for very-high-risk patients (strength of recommendation [SOR]: C...
When are antibiotics indicated for acute COPD exacerbations?
(Family Physicians Inquiries Network, 2006)
). Antibiotics may be prescribed in the outpatient setting for those with severe exacerbations (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 ...
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...
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...
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...
Missouri hospitalist, issue 29 (2010 May 27)
(University of Missouri. Department of Medicine. Division of Hospital Medicine, 2010-05)
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 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...
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...