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What are appropriate screening tests for adolescents?
(Family Physicians Inquiries Network, 2006)
Screen all women of childbearing age, including adolescents, for rubella susceptibility (strength of recommendation [SOR]: B). Screen all sexually active adolescent females for chlamydia (SOR: A), gonorrhea (SOR: B), and ...
What are hospital admission criteria for infants with bronchiolitis?
(Family Physicians Inquiries Network, 2006)
Clinical judgment remains the gold standard for hospital admission of infants with bronchiolitis, and it cannot be replaced by objective criteria (strength of recommendation [SOR]: B, based on prospective and retrospective cohort and retrospective...
Are major bleeding events from falls more likely in patients on warfarin?
(Family Physicians Inquiries Network, 2006)
There is no evidence of increased risk for major bleeding as a result of falls in hospitalized patients taking warfarin (strength of recommendation [SOR]: B, based on retrospective cohort studies). In the average patient ...
Are oral agents effective for the treatment of verruca vulgaris?
(Family Physicians Inquiries Network, 2006)
Of the available oral therapies for common warts, none has sufficient evidence to recommend it as an effective therapy (strength of recommendation [SOR]: B). To date, no oral agent has been shown to be effective in a ...
Which vaccinations are indicated after splenectomy?
(Family Physicians Inquiries Network, 2006)
of clinical trials for meningococcal and Hib vaccines)....
Urine Dipstick for Diagnosing Urinary Tract Infection
(Family Physicians Inquiries Network, 2006)
The sensitivity and specificity of the urine dipstick varies somewhat with the setting and population, as does its recommended interpretation. In low-risk patients with a low pretest probability of UTI, the urine dipstick ...
Treatments for Chronic Prostatitis
(Family Physicians Inquiries Network, 2006)
Because the etiology of chronic nonbacterial prostatitis is unknown, a variety of treatments have been proposed. The best- designed, largest clinical trials have not found the most commonly used therapies (i.e., alpha blockers, quinolone antibiotics...
Psychosocial Interventions Delivered by Primary Care Physicians to Patients with Depression
(Family Physicians Inquiries Network, 2006)
Few high-quality studies have been conducted examining the effectiveness of psychosocial interventions performed by primary care physicians for patients with major depression. Two randomized controlled clinical trials (RCTs) found that a...
What is the recommended approach to asymptomatic patients who develop a reactive PPD?
(Family Physicians Inquiries Network, 2006)
Clinical evaluation and chest x-ray are recommended for asymptomatic patients with a positive purified protein derivative (PPD) test result, to exclude the slight possibility of active tuberculosis (TB). Patients with radiographic evidence of old...
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...
Does treatment with donepezil improve memory for patients with mild cognitive impairment?
(Family Physicians Inquiries Network, 2006)
Donepezil (Aricept) has potential benefit in delaying risk of progression to Alzheimer's disease in the first year of treatment, but this benefit is not seen at 3 years. Donepezil does not improve memory for patients with ...
Should patients receive 23-valent pneumococcal vaccination more than once?
(Family Physicians Inquiries Network, 2006)
No patient-oriented evidence supports pneumococcal revaccination of any patient (high-risk or otherwise). Antibody levels may be augmented by revaccination; however, the clinical efficacy of revaccination, even among high-risk patients, is unknown...
What is the best way to diagnose polycystic ovarian syndrome?
(Family Physicians Inquiries Network, 2006)
ovaries with multiple small follicular cysts on transvaginal ultrasound (strength of recommendation [SOR]: C, based on expert opinion). Depending on the clinical presentation, secondary causes should be excluded (SOR: C, expert opinion). While not among...
How do we decide when a patient with nonmalignant disease is eligible for hospice care?
(Family Physicians Inquiries Network, 2006)
the unpredictable course of common noncancer chronic diseases. Hospice eligibility for patients with nonmalignant disease is based on clinical judgment....
A1C Testing in the Diagnosis of Diabetes Mellitus
(Family Physicians Inquiries Network, 2006)
A1C testing is highly specific compared with a two-hour oral glucose tolerance test (OGTT) or a fasting plasma glucose test. However, because A1C testing is not sensitive enough to rule out diabetes if levels are normal, ...
What is the best medical therapy for new-onset type 2 diabetes?
(Family Physicians Inquiries Network, 2006)
Sulfonylureas, metformin, thiazolidinediones, and non-sulfonylurea secretagogues differ little in their ability to decrease glycosylated hemoglobin (HbA1c) levels when used as initial monotherapy for diabetes mellitus type ...
What is the best duration of steroid therapy for contact dermatitis (rhus)?
(Family Physicians Inquiries Network, 2006)
Scant evidence exists for the best duration of steroid therapy for contact dermatitis due to plants (rhus). Review articles recommend 10 to 21 days of treatment with topical or oral corticosteroids for moderate to severe ...
What is the most effective management of acute fractures of the base of the fifth metatarsal?
(Family Physicians Inquiries Network, 2006)
For acute Jones' fractures in recreationally active patients, early intramedullary screw fixation results in lower failure rates and shorter times to both clinical union and return to sports than non-weightbearing short leg casting (strength...
Glucosamine and Chondroitin for Osteoarthritis
(Family Physicians Inquiries Network, 2006)
Glucosamine reduces pain and improves function in patients with knee or hip osteoarthritis. (Strength of recommendation: B, based on systematic reviews and a meta-analysis) Glucosamine may be beneficial in other forms of ...
What is the dietary treatment for low HDL cholesterol?
(Family Physicians Inquiries Network, 2006)
Low-carbohydrate diets raise high-density lipoprotein (HDL) cholesterol levels by approximately 10%; soy protein with isoflavones raises HDL by 3% (strength of recommendation [SOR]: C, based on meta-analysis of physiologic ...