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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 ...
Group Medical Visits for the Management of Chronic Pain
(Family Physicians Inquiries Network, 2007)
Improvements of possible practical significance were seen for various clinical measures in studies of group treatment sessions for patients with back pain, arthritis, and rheumatic disease. However, studies on group treatment for patients...
Which tool is most useful in diagnosing bipolar disorder in children?
(Family Physicians Inquiries Network, 2007)
No single, well-validated screening instrument for clinical diagnosis of bipolar disorder in children exists. That said, the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS), a semi-structured interview, along with clinical...
Angiotensin Blockade in Patients with Diabetic Nephropathy
(Family Physicians Inquiries Network, 2007)
When used to delay the progression of early nephropathy in patients with type 2 diabetes mellitus, angiotensin receptor blockers (ARBs) are not superior to angiotensin-converting enzyme (ACE) inhibitors. (Strength of ...
Which oral antifungal is best for toenail onychomycosis?
(Family Physicians Inquiries Network, 2007)
Terbinafine, 250 mg taken daily for 12 weeks, is the best regimen for toenail onychomycosis due to better clinical and mycologic cure rates, tolerability, and cost effectiveness (strength of recommendation [SOR]: A, meta-analyses)....
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 ...
Treatment of Impetigo
(Family Physicians Inquiries Network, 2007)
Topical mupirocin (Bactroban) and fusidic acid (not available in the United States) are more effective than placebo and at least as effective as oral antibiotics for the treatment of limited impetigo, and are better ...
How can you best diagnose idiopathic normal pressure hydrocephalus?
(Family Physicians Inquiries Network, 2007)
Diagnose idiopathic normal pressure hydrocephalus (INPH) by clinical history, brain imaging, physical findings, and physiological criteria. The clinical examination must show the characteristic gait disturbance and either impaired cognition...
What's the best way to screen for anxiety and panic disorders?
(Family Physicians Inquiries Network, 2007)
The GAD-7 has the best evidence and utility in the primary care setting for generalized anxiety disorder (strength of recommendation [SOR]: A), while the proprietary Quick PsychoDiagnostics Panel (QPD) has the best operating ...
Should you treat a symptomatic patient by phone when his child has confirmed strep throat?
(Family Physicians Inquiries Network, 2007)
on consensus guidelines) due to poor diagnostic accuracy. When you suspect GABHS pharyngitis either clinically or epidemio-logically, confirm the diagnosis of pharyngitis by a laboratory test. Patients with a positive throat culture or a rapid antigen detection...
What's the best treatment for gestational diabetes?
(Family Physicians Inquiries Network, 2007)
There is no single approach to glycemic control that is better than another for reducing neonatal mortality and morbidity. Glycemic control--regardless of whether it involves diet, glyburide, or insulin--leads to fewer ...
How should you further evaluate an adult with a testicular mass?
(Family Physicians Inquiries Network, 2007)
in which ultrasound and clinical exam are inconclusive or confl- icting, magnetic resonance imaging (MRI) can provide additional information to improve management and decrease unnecessary surgery (SOR: B, based on cohort trials of patient-oriented outcomes)....
Which nondrug alternatives can help with insomnia?
(Family Physicians Inquiries Network, 2007)
Cognitive behavioral therapy (CBT) interventions -- particularly stimulus control and sleep hygiene -- are well-validated, effective treatments for chronic insomnia that are equivalent or superior to pharmacological ...
Which tests are the most useful for diagnosing PID?
(Family Physicians Inquiries Network, 2007)
No single test has adequate sensitivity and specificity to reliably identify pelvic inflammatory disease (PID) and thus help to spare women serious sequelae, including infertility (strength of recommendation [SOR]: B, based ...
Should we use appetite stimulants for malnourished elderly patients?
(Family Physicians Inquiries Network, 2007)
Only 1 appetite stimulate, megestrol acetate oral suspension (Megace) at 400 mg or 800 mg daily, has been studied in this population. The data show only limited benefit, mixed outcomes, and potential harm (strength of ...
Can you differentiate bacterial from viral pediatric infections based on the CBC?
(Family Physicians Inquiries Network, 2007)
No--the complete blood count (CBC) alone does not have adequate sensitivity or specificity to tell bacterial from viral infections (strength of recommendation [SOR]: B, cohort studies). When used in conjunction with other clinical parameters...
What is the best approach to the evaluation of resting tachycardia for an adult?
(Family Physicians Inquiries Network, 2007)
The best evidence about the diagnostic evaluation of resting tachycardias in adults is currently outlined by practice guidelines. 1 Initial evaluation includes clinical history, physical examination, and 12-lead electrocardiogram (ECG...
Does bed rest for preeclampsia improve neonatal outcomes?
(Family Physicians Inquiries Network, 2007)
No. Strict bed rest in the hospital for pregnant women with preeclampsia does not appear to lower rates of perinatal mortality, neonatal mortality, or neonatal morbidity, including preterm birth, endotracheal intubations, ...
What other STI testing should we do for a patient with chlamydia?
(Family Physicians Inquiries Network, 2007)
Testing for gonorrhea is recommended for a patient with genital chlamydia; also test for gonorrhea and chlamydia in their sexual partner because of the high prevalence of coinfection, particularly among younger patients ...
What is the best initial treatment for orbital cellulitis in children?
(Family Physicians Inquiries Network, 2007)
Although antibiotics are the best initial treatment, surgical intervention is warranted when a child has: visual impairment, complete ophthalmoplegia, or well-defined abscess on presentation, or no clearly apparent clinical improvement by 24 hours...