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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)....
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 ...
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 ...
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 ...
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 ...
Which Lipoprotein Measurements Are Clinically Useful?
(Family Physicians Inquiries Network, 2007)
for routine cardiovascular risk screening. (Strength of Recommendation [SOR]: C, based on expert opinion and lack of clinical outcomes trials)...
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 ...
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 ...
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...
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 ...
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...
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 for diabetes: Monitor microalbuminuria?
(Family Physicians Inquiries Network, 2007)
No studies address whether continued screening for microalbuminuria once a patient is taking an angiotensin-converting enzyme (ACE) inhibitor or angiotensin-2 receptor blocker (ARB) improves outcomes. Indirect evidence and ...
Clinical Indicators of Obstructive Sleep Apnea
(Family Physicians Inquiries Network, 2011)
Clinical indicators (e.g., sex, snoring severity, history of apnea, age, menopausal status, waist-to-hip ratio, body habitus) can predict OSA as diagnosed using overnight polysomnography or sleep study. (Strength of Recommendation: B, based...
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...
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, ...
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)....
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's the best diagnostic evaluation of night sweats?
(Family Physicians Inquiries Network, 2007)
of recommendation [SOR]: C, based on usual practice and clinical opinion). No clinical trials have directly studied symptomatic relief of night sweats alone....
Monitoring Therapy for Patients with Alzheimer's Disease
(Family Physicians Inquiries Network, 2007)
Patients with Alzheimer's disease who undergo treatment of any kind should be monitored eight weeks after initiation of therapy and at least every six months thereafter. (Strength of Recommendation: C, based on expert ...