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In patients with a previous CVA, do antioxidants protect against subsequent stroke?
(Family Physicians Inquiries Network, 2002)
Most recent randomized controlled clinical trials have not found a benefit in antioxidants (vitamin C, vitamin E, and/or beta-carotene) for preventing cardiovascular disease, including stroke. These recent clinical studies have not confirmed earlier...
When should acute nonvenereal conjunctivitis be treated with topical antibiotics?
(Family Physicians Inquiries Network, 2002)
Children with suspected or culture-proven acute nonvenereal bacterial conjunctivitis should be treated with topical antibiotics, which hastens clinical and microbiological remission and may prevent potentially serious morbidity. In light of recent...
What Clinical Findings Can Be Used to Diagnose Deep Venous Thrombosis?
(Family Physicians Inquiries Network, 2004)
No single clinical finding can accurately diagnose DVT. [Strength of recommendation: A, based on a systematic review of homogeneous validating cohort studies with good reference standards.] However, when organized into clinical decision rules (CDRs...
Does a low-salt diet reduce morbidity and mortality in congestive heart failure?
(Family Physicians Inquiries Network, 2002)
of congestive heart failure exacerbation.(Grade of recommendation: D.) Clinical trials of multifactorial, nondrug interventions have shown an association of sodium restriction with reduced morbidity and improved quality of life in some populations...
Is there a role for theophylline in treating patients with asthma?
(Family Physicians Inquiries Network, 2002)
With adults, oral theophylline may help lower the dosage of inhaled steroids needed to control chronic asthma. It offers no benefit for acute asthma exacerbations. For children, intravenous aminophylline may improve the clinical course of severe...
What is the initial approach to the treatment of shoulder pain?
(Family Physicians Inquiries Network, 2002)
reviews and randomized clinical trials with inconsistent and inconclusive results)...
What is the best way to evaluate acute diarrhea?
(Family Physicians Inquiries Network, 2002)
-risk patients who have been hospitalized for 3 or more days) leads to a more rational use of stool cultures without missing cases of clinically significant disease. (Grade of recommendation: D, based on limited studies, reliance on expert opinion, and consensus.)...
How often is coughing the presenting complaint in patients with gastroesophageal reflux disease?
(Family Physicians Inquiries Network, 2002)
Frequent coughing is a concern for approximately 35% of those with typical gastroesophageal reflux disease (GERD) symptoms of heartburn and acid regurgitation as compared with 11% in those who do not have these symptoms. Among pulmonary clinic...
Does ambulatory blood pressure monitoring aid in the management of patients with hypertension?
(Family Physicians Inquiries Network, 2002)
disorders of pregnancy; and identifying nocturnal hypertension. (Grade of recommendation: B, based on consistent cohort studies and trials, requiring extrapolation in certain clinical circumstances)...
How beneficial are thiazolidinediones for diabetes mellitus?
(Family Physicians Inquiries Network, 2002)
The thiazolidinediones pioglitazone (Actos) and rosiglitazone (Avandia) are effective at lowering fasting plasma glucose (FPG) and glycosylated hemoglobin (Hb A1c) in patients with type 2 diabetes when used either as ...
How effective are exercise and physical therapy for chronic low back pain?
(Family Physicians Inquiries Network, 2002)
Exercise is more effective for chronic low back pain than treatment with medication plus return to usual activity and as effective as conventional physiotherapy. The evidence is less consistent in showing that any particular ...
What is the prognosis for acute low back pain?
(Family Physicians Inquiries Network, 2002)
The proportion of patients who are pain free or completely recovered after an acute episode of low back pain within 2 weeks to 6 months ranges from 21% to 90%, depending on the population studied and the method of measuring ...
Does postcoital voiding prevent urinary tract infections in young women?
(Family Physicians Inquiries Network, 2002)
Healthy women who urinate within 15 minutes of sexual intercourse may be slightly less likely to develop a urinary tract infection (UTI) than women who do not urinate afterward (grade of recommendation: D, extrapolation ...
What is the most effective treatment for external genital warts?
(Family Physicians Inquiries Network, 2002)
Podofilox (Condylox), imiquimod (Aldara), cryotherapy, and surgical options all seem reasonable alternatives that are superior to podophyllin. (Grade of recommendation: B, based on systematic review.) No studies of surgical ...
What is the best treatment for impacted cerumen?
(Family Physicians Inquiries Network, 2002)
Docusate sodium given 15 minutes before irrigation is most effective for facilitating cerumen removal during a single office visit. (Grade of recommendation: B, based on head-to-head trials that lacked irrigationonly arms.) ...
Are any oral iron formulations better tolerated than ferrous sulfate?
(Family Physicians Inquiries Network, 2002)
Ferrous salt preparations (ferrous sulfate, ferrous gluconate, and ferrous fumarate) are equally tolerable. (Grade of recommendation: A, based on randomized controlled trial.) Controlled-release iron preparations cause ...
How effective are nasal steroids combined with nonsedating antihistamines for seasonal allergic rhinitis?
(Family Physicians Inquiries Network, 2002)
For treating seasonal allergic rhinitis, inhaled nasal corticosteroids are superior to nonsedating antihistamines (Grade of recommendation: A, based on a large meta-analysis of randomized controlled trials [RCTs]). Combining ...
What environmental modifications improve pediatric asthma?
(Family Physicians Inquiries Network, 2002)
Reducing environmental tobacco smoke exposure decreases health care utilization among poor asthmatic children. Dust mite reduction by chemical measures is potentially harmful. (Grade of recommendations: B, based on single ...
When should patients with asymptomatic aortic stenosis be evaluated for valve replacement?
(Family Physicians Inquiries Network, 2002)
For patients whose echocardiograms show advanced calcification of the aortic valves, a jet velocity of > 4.0 m/s, or a progression in jet velocity of 0.3m/s/year; and for patients who have an abnormal exercise response or ...
What are the indications for tonsillectomy in children?
(Family Physicians Inquiries Network, 2002)
Tonsillectomy with or without adenoidectomy is minimally effective when combined with tympanostomy tube placement in preventing recurrent otitis media in the 3 years following surgery. The risks of surgery must be weighed ...