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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 risk factors contribute to C difficile diarrhea?
(Family Physicians Inquiries Network, 2011)
). Hospital risk factors include proximity to other patients with C difficile and longer length of stay (SOR: B, several good-quality cohort studies). Patient risk factors include advanced age and comorbid conditions (SOR: B, several good-quality cohort...
Antidepressant Use During Pregnancy
(Family Physicians Inquiries Network, 2011)
There are no studies that have shown any antidepressant to be absolutely safe for use during any stage of pregnancy. The use of selective serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants (TCAs) during ...
Preventing Acute Mountain Sickness
(Family Physicians Inquiries Network, 2011)
Gradual ascent is the most effective method for preventing acute mountain sickness. (Strength of Recommendation [SOR]: B, based on good-quality prospective and retrospective cohort studies.) Acetazolamide should be used ...
Antibody Testing for Systemic Lupus Erythematosus
(Family Physicians Inquiries Network, 2011)
Antibody testing plays an important role when assessing patients, but should not be used alone to diagnose SLE. (Strength of Recommendation: C, based on expert opinion.) The antinuclear antibody (ANA) test is the most commonly used screening test...
Are serum uric acid levels always elevated in acute gout?
(Family Physicians Inquiries Network, 2011)
Many patients with acute gout (11%-49%) have normal serum uric acid (SUA) levels (strength of recommendation [SOR]: A, prospective cohort studies). Patients taking allopurinol are significantly more likely to have normal ...
How best to diagnose asthma in infants and toddlers?
(Family Physicians Inquiries Network, 2011)
the probability of a subsequent asthma diagnosis in the absence of other causes (strength of recommendation: B, 2 good-quality cohort studies)....
What's best for croup?
(Family Physicians Inquiries Network, 2011)
in moderate-to-severe croup (SOR: C, limited-quality disease-oriented evidence). The role of heliox in moderate to severe croup remains uncertain. Studies to date have been inadequate (SOR: C, limited-quality disease-oriented evidence). Humidified air provides...
Which regimen treats vitamin D deficiency most effectively?
(Family Physicians Inquiries Network, 2011)
). Vitamin D3 (cholecalciferol) may increase serum 25-hydroxy vitamin D (25[OH]D) concentrations more effectively than vitamin D2 (ergocalciferol) (SOR: C, a single RCT of disease-oriented outcomes)....
Treatment of Hyperhidrosis
(Family Physicians Inquiries Network, 2011)
). Topical aluminum chloride (Drysol) is effective for the treatment of palmar hyperhidrosis. (SOR: B, based on one small controlled study). Iontophoresis is effective for treating palmar, plantar, and axillary hyperhidrosis. (SOR: C, based on one unblinded...
What is the best way to treat Morton's neuroma?
(Family Physicians Inquiries Network, 2011)
by corticosteroid injections and, finally, surgery (strength of recommendation [SOR]: C, case series). Injecting sclerosing alcohol depends on the provider's access to and comfort with ultrasound, but the evidence is insufficient to recommend it routinely (SOR: C...
Which medications benefit patients with diastolic heart failure?
(Family Physicians Inquiries Network, 2011)
of recommendation [SOR]: C, 1 prospective cohort trial with matched controls), propranolol (SOR: B, 1 randomized controlled trial [RCT]), and statins (SOR: C, 1 prospective cohort trial). Furosemide improves symptoms of heart failure and quality of life (SOR: C, 1...
What is the most effective way to treat recurrent canker sores?
(Family Physicians Inquiries Network, 2011)
Amlexanox appears to be most effective overall. Amlexanox 5% paste reduces ulcer size, pain duration, and healing time (strength of recommendation [SOR]: A, multiple randomized controlled trials [RCTs]). Topical steroids ...
Melanoma
(Family Physicians Inquiries Network, 2011)
This issue of eMedRef provides information to clinicians on the pathophysiology, diagnosis, and therapeutics of melanoma.
Can probiotics safely prevent recurrent vaginitis?
(Family Physicians Inquiries Network, 2011)
Using vaginal suppositories or eating yogurt with Lactobacillus may reduce recurrences of bacterial vaginosis (BV) (strength of recommendation [SOR]: B, randomized controlled trials [RCTs] with conflicting results). Neither ...
Pharmacologic therapy for vitamin D deficiency
(Family Physicians Inquiries Network, 2013)
trials [RCTs].) Cholecalciferol produces higher serum 25-hydroxyvitamin D levels than ergocalciferol (vitamin D2). Vitamin D therapy may be given daily or weekly with equal effectiveness; the dosage depends on the degree of deficiency. (SOR: C, based...
What's the best way to predict the success of a trial of labor after a previous C-section?
(Family Physicians Inquiries Network, 2015)
Q: What's the best way to predict the success of a trial of labor after a previous C-section? Evidence-based answer: while 8 scoring tools predict success rates for a trial of labor after previous cesarean section (TOLAC), it's unclear which...
Human parathyroid hormone for treating osteoporosis
(Family Physicians Inquiries Network, 2012)
].) The parathyroid hormone teriparatide (Forteo) should be reserved for patients who do not respond to bisphosphonates or who have severe bone loss. (SOR: C, based on expert opinion.)...
Effect of corticosteroids on pain and function in knee osteoarthritis patients
(Family Physicians Inquiries Network, 2020)
Clinical Inquiries question: Does the type of corticosteroid have an effect on pain and functional status of the knee in osteoarthritis (OA) patients receiving intra-articular injections? Evidence-based answer: In patients with knee OA, the type...
How best to diagnose iron-deficiency anemia in patients with inflammatory disease?
(Family Physicians Inquiries Network, 2012)
The serum ferritin level is the most sensitive and specific initial laboratory test for iron- deficiency anemia (IDA) in patients with inflammation. Serum ferritin levels <45 ng/dL confirm IDA, and levels of ≥100 ng/dL ...