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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 ...
How accurate is the clinical diagnosis of pneumonia?
(Family Physicians Inquiries Network, 2003)
No element or combination of elements from the clinical history and physical examination are sufficiently sensitive or specific to confirm or exclude acute community-acquired pneumonia (CAP). A chest x-ray is recommended to make the diagnosis (Grade...
What is the clinical workup for failure to thrive?
(Family Physicians Inquiries Network, 2008)
The clinical evaluation of failure to thrive (FTT) includes a thorough history and physical examination; observation of parent-child interactions; observation and documentation of the child's feeding patterns; and a home visit by an appropriately...
When should acute nonvenereal conjunctivitis be treated with topical antibiotics?
(Family Physicians Inquiries Network, 2002)
of recommendation: C, based on extrapolation from systematic reviews of specialty clinic trials and cohort studies.)...
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...
How should we monitor men receiving testosterone replacement therapy?
(Family Physicians Inquiries Network, 2010)
symptom response to testosterone are also recommended, although direct evidence is lacking (SOR: C, consensus opinion). Monitoring lipid levels is unnecessary (SOR: A, based on several meta-analyses), as is monitoring testosterone levels (SOR C, consensus...
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 ...
How should you manage children born to hepatitis C-positive women?
(Family Physicians Inquiries Network, 2010)
for starters, don't be overly concerned with the mode of delivery; it doesn't influence the rate of transmission of hepatitis C virus (HCV), except in women who are also infected with human immunodeficiency virus (HIV) (strength of recommendation...
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...
Are breast self-exams or clinical exams effective for screening breast cancer?
(Family Physicians Inquiries Network, 2005)
]). Clinical breast examination is an important means of averting some deaths from breast cancer, but demands careful attention to technique and thoroughness (SOR: B, extrapolating from a high-quality RCT)....
Does screening for diabetes in at-risk patients improve long-term outcomes?
(Family Physicians Inquiries Network, 2004)
No randomized clinical trials or prospective studies have demonstrated adequate evidence to screen individuals for diabetes mellitus. A recently published meta-analysis for the United States Preventative Services Task Force (USPSTF) stated...
What's the best way to manage athletes with amenorrhea?
(Family Physicians Inquiries Network, 2008)
the return of normal menses (strength of recommendation: C, expert consensus)....
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...
What is the most effective way to relieve symptoms of acute stress disorder?
(Family Physicians Inquiries Network, 2010)
of appearance of symptoms, unless distress is too severe to be managed with psychological treatment alone (SOR: C, consensus guideline)....
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...
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 you test or treat partners of patients with gonorrhea, chlamydia, or trichomoniasis?
(Family Physicians Inquiries Network, 2010)
Empiric treatment of partners of female or heterosexual male patients diagnosed with gonorrhea or chlamydia using expedited partner therapy (having the index patient deliver therapy to the partner) decreases the risk of ...